Effects of Early Language Deprivation on Brain Connectivity: Language Pathways in Deaf Native and Late First-Language Learners of American Sign Language

The Acquisition of a Diglossic Language by Deaf and Hard of Hearing Students: Evidence From a Sentence Production Task

PURPOSE

The current study aimed to examine morphosyntactic errors in sentences produced by DHH students, who are signers of Israeli Sign Language, and also users of Palestinian Colloquial Arabic (PCA) and written Modern Standard Arabic (MSA).

METHOD

Nineteen school-age DHH students participated in a sentence elicitation task in which they retold events portrayed in 24 videos in PCA and MSA. A control group of 19 hearing students was tested with the same task. Sentences in each language variety were coded for grammatical versus ungrammatical productions and for type of morphosyntactic errors for the latter. In addition, code-switched words were counted.

RESULTS

The hearing group showed no morphosyntactic errors, whereas the DHH students showed morphosyntactic errors in both PCA and MSA. In addition, both groups code-switched in both PCA and MSA, with more code-switching in the MSA task than in the PCA task. Furthermore, an interaction with age revealed that young students code-switched more in MSA and older students code-switched more in PCA.

CONCLUSIONS

It is suggested that the morphosyntactic abilities of DHH students are incomplete in both language varieties. Lack of spoken language input may negatively influence the acquisition of spoken language, which impacts further the acquisition of the standard language in diglossic contexts. Code-switching is explained as both due to lexical gaps, when occurring in MSA, and an effort to raise the register in PCA.

Verbal working memory and syntactic comprehension segregate into the dorsal and ventral streams

Syntactic processing and verbal working memory are both essential components to sentence comprehension. Nonetheless, the separability of these systems in the brain remains unclear. To address this issue, we performed causal-inference analyses based on lesion and connectome network mapping using MRI and behavioral testing in 103 individuals with chronic post-stroke aphasia. We employed a rhyme judgment task with heavy working memory load without articulatory confounds, controlling for the overall ability to match auditory words to pictures and to perform a metalinguistic rhyme judgment, isolating the effect of working memory load. We assessed noncanonical sentence comprehension, isolating syntactic processing by incorporating residual rhyme judgment performance as a covariate for working memory load. Voxel-based lesion analyses and structural connectome-based lesion symptom mapping controlling for total lesion volume were performed, with permutation testing to correct for multiple comparisons (4,000 permutations). We observed that effects of working memory load localized to dorsal stream damage: posterior temporal-parietal lesions and frontal-parietal white matter disconnections. These effects were differentiated from syntactic comprehension deficits, which were primarily associated with ventral stream damage: lesions to temporal lobe and temporal-parietal white matter disconnections, particularly when incorporating the residual measure of working memory load as a covariate. Our results support the conclusion that working memory and syntactic processing are associated with distinct brain networks, largely loading onto dorsal and ventral streams, respectively.

Syntax intervention in American Sign Language: an exploratory case study

This case study describes the use of a syntax intervention with two deaf children who did not acquire a complete first language (L1) from birth. It looks specifically at their ability to produce subject-verb-object (SVO) sentence structure in American Sign Language (ASL) after receiving intervention. This was an exploratory case study in which investigators utilized an intervention that contained visuals to help teach SVO word order to young deaf children. Baseline data were collected over three sessions before implementation of a targeted syntax intervention and two follow-up sessions over 3-4 weeks. Both participants demonstrated improvements in their ability to produce SVO structure in ASL in 6-10 sessions. Visual analysis revealed a positive therapeutic trend that was maintained in follow-up sessions. These data provide preliminary evidence that a targeted intervention may help young deaf children with an incomplete L1 learn to produce basic word order in ASL. Results from this case study can help inform the practice of professionals working with signing deaf children who did not acquire a complete L1 from birth (e.g., speech-language pathologists, deaf mentors/coaches, ASL specialists, etc.). Future research should investigate the use of this intervention with a larger sample of deaf children.

Family-Centered Early Intervention Deaf/Hard of Hearing (FCEI-DHH): Support Principles

This article is the sixth in a series of eight articles that comprise a special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. The Support Principles article is the second of three articles that describe the 10 Principles of FCEI-DHH, preceded by the Foundation Principles, and followed by the Structure Principles, all in this special issue. The Support Principles are composed of four Principles (Principles 3, 4, 5, and 6) that highlight (a) the importance of a variety of supports for families raising children who are DHH; (b) the need to attend to and ensure the well-being of all children who are DHH; (c) the necessity of building the language and communication abilities of children who are DHH and their family members; and (d) the importance of considering the family's strengths, needs, and values in decision-making.

Hearing and sociality: the implications of hearing loss on social life

Hearing is essential to the formation of social relationships and is the principal afferent of social life. Yet hearing loss, which is one of the most prevalent forms of sensory disability worldwide and is critical for social development, has received little attention from the social interventionalist perspective. The purpose of this mini-review is to describe the basic neurobiological principles of hearing and to explore the reciprocal relationships between social support, hearing loss, and its psychosocial comorbidities. We also discuss the role of social enrichment in sensorineural recovery and identify open questions within the fields of hearing physiology and social networks.

Comparative physiological anthropogeny: exploring molecular underpinnings of distinctly human phenotypes

Anthropogeny is a classic term encompassing transdisciplinary investigations of the origins of the human species. Comparative anthropogeny is a systematic comparison of humans and other living nonhuman hominids (so-called "great apes"), aiming to identify distinctly human features in health and disease, with the overall goal of explaining human origins. We begin with a historical perspective, briefly describing how the field progressed from the earliest evolutionary insights to the current emphasis on in-depth molecular and genomic investigations of "human-specific" biology and an increased appreciation for cultural impacts on human biology. While many such genetic differences between humans and other hominids have been revealed over the last two decades, this information remains insufficient to explain the most distinctive phenotypic traits distinguishing humans from other living hominids. Here we undertake a complementary approach of "comparative physiological anthropogeny," along the lines of the preclinical medical curriculum, i.e., beginning with anatomy and considering each physiological system and in each case considering genetic and molecular components that are relevant. What is ultimately needed is a systematic comparative approach at all levels from molecular to physiological to sociocultural, building networks of related information, drawing inferences, and generating testable hypotheses. The concluding section will touch on distinctive considerations in the study of human evolution, including the importance of gene-culture interactions.

Associations of childhood hearing loss and adverse childhood experiences in deaf adults

Childhood trauma and adverse childhood experiences have a strong relationship with health disparities across the lifespan. Despite experiencing approximately doubled rates of trauma, Adverse Childhood Experiences (ACEs) are poorly characterized in deaf populations. We sought to characterize deaf-specific demographic factors and their association with multiple experiences of ACEs before the age of 18 years old. An analytical cross-sectional approach was used to ascertain associations of deaf-specific demographic factors and experiences with ACEs. The complete dataset included 520 participants for a total response rate of 56%. After adjusting for confounding effects, less severe hearing loss of 16-55 dB (2+ OR: 5.2, 4+ OR: 4.7), having a cochlear implant (2+ OR: 2.1, 4+ OR: 2.6), and not attending at least one school with signing access (2+ OR: 2.4, 4+ OR: 3.7) were significantly and independently associated with reported experiences of multiple ACEs. We conclude that factors associated with childhood hearing loss and language experiences increase risk of experiencing ACEs. Given the strong relationship between ACEs and poor social outcomes, early intervention clinical practice and health policies should consider interventions to support healthy home environments for deaf children.

Verbal, Figural, and Arithmetic Fluency of Children with Cochlear Implants

Cochlear implantation gives children with prelingual severe hearing loss and deafness the opportunity to develop their hearing abilities, speech, language, cognitive abilities and academic skills with adequate rehabilitation. The aim of the research was to analyze verbal, figural and arithmetic fluency and their interrelationship in children with a cochlear implant (CI) and children with normal hearing (NH). A total of 46 children with CI and 110 children with NH, aged 9 to 16, participated in the research. Verbal fluency was assessed using phonemic and semantic fluency, and non-verbal fluency using figural fluency. Arithmetic fluency was assessed using simple arithmetic tasks within the number range up to 100. The results showed that children with CI achieved poorer results in phonemic fluency (z = -4.92; p < 0.001), semantic fluency (z = -3.89; p < 0.001), figural fluency (z = -3.07; p = 0.002), and arithmetic fluency (z = -4.27; p < 0.001). In both groups, a positive correlation was obtained between the measured modalities and types of fluency. In the group of children with CI, a sex difference was obtained on the phonemic fluency test, in favor of girls. The age of children with CI was correlated with arithmetic fluency. Verbal, figural and arithmetic fluency of children with CI speak in favor of the importance of early auditory and language experiences.

Subcortical language localization using sign language and awake craniotomy for dominant posterior temporal glioma resection in a hearing-impaired patient

Intraoperative direct cortical stimulation (DCS) is the gold standard technique to maximize the extent of resection of tumors located in eloquent areas. To date, there are three cases reported of awake mapping for language centers in deaf patients who could communicate only with sign language. We present the case of DCS in a deaf patient who could communicate vocally, native to American Sign Language and English, that underwent intraoperative awake mapping. DCS showed similar disruption of expressive phonology to both pictorial and gestural stimuli, confirming that sign language follows the same pattern as oral language.

Learning a Sign Language Does Not Hinder Acquisition of a Spoken Language

PURPOSE

The purpose of this study is to determine whether and how learning American Sign Language (ASL) is associated with spoken English skills in a sample of ASL-English bilingual deaf and hard of hearing (DHH) children.

METHOD

This cross-sectional study of vocabulary size included 56 DHH children between 8 and 60 months of age who were learning both ASL and spoken English and had hearing parents. English and ASL vocabulary were independently assessed via parent report checklists.

RESULTS

ASL vocabulary size positively correlated with spoken English vocabulary size. Spoken English vocabulary sizes in the ASL-English bilingual DHH children in the present sample were comparable to those in previous reports of monolingual DHH children who were learning only English. ASL-English bilingual DHH children had total vocabularies (combining ASL and English) that were equivalent to same-age hearing monolingual children. Children with large ASL vocabularies were more likely to have spoken English vocabularies in the average range based on norms for hearing monolingual children.

CONCLUSIONS

Contrary to predictions often cited in the literature, acquisition of sign language does not harm spoken vocabulary acquisition. This retrospective, correlational study cannot determine whether there is a causal relationship between sign language and spoken language vocabulary acquisition, but if a causal relationship exists, the evidence here suggests that the effect would be positive. Bilingual DHH children have age-expected vocabularies when considering the entirety of their language skills. We found no evidence to support recommendations that families with DHH children avoid learning sign language. Rather, our findings show that children with early ASL exposure can develop age-appropriate vocabulary skills in both ASL and spoken English.

Restricted language access during childhood affects adult brain structure in selective language regions

Due to the ubiquitous nature of language in the environment of infants, how it affects the anatomical structure of the brain language system over the lifespan is not well understood. In this study, we investigated the effects of early language experience on the adult brain by examining anatomical features of individuals born deaf with typical or restricted language experience in early childhood. Twenty-two deaf adults whose primary language was American Sign Language and were first immersed in it at ages ranging from birth to 14 y participated. The control group was 21 hearing non-signers. We acquired T1-weighted magnetic resonance images and used FreeSurfer [B. Fischl, Neuroimage 62, 774-781(2012)] to reconstruct the brain surface. Using an a priori regions of interest (ROI) approach, we identified 17 language and 19 somatomotor ROIs in each hemisphere from the Human Connectome Project parcellation map [M. F. Glasser et al., Nature 536, 171-178 (2016)]. Restricted language experience in early childhood was associated with negative changes in adjusted grey matter volume and/or cortical thickness in bilateral fronto-temporal regions. No evidence of anatomical differences was observed in any of these regions when deaf signers with infant sign language experience were compared with hearing speakers with infant spoken language experience, showing that the effects of early language experience on the brain language system are supramodal.

Effects of Age-of-Acquisition on Proficiency in Polish Sign Language: Insights to the Critical Period Hypothesis

This study focuses on the relationship between the age of acquisition of Polish Sign Language (PJM) by deaf individuals and their receptive language skills at the phonological, morphological and syntactic levels. Sixty Deaf signers of PJM were recruited into three equal groups (n = 20): (1) a group exposed to PJM from birth from their deaf parents; (2) a group of childhood learners of PJM, who reported learning PJM between 4 and 8 years; (3) a group of adolescent learners of PJM, who reported learning PJM between 9 and 13 years. The PJM Perception and Comprehension Test was used to assess three aspects of language processing: phonological, morphological and syntactic. Participants were asked to decide whether a series of signs and sentences were acceptable in PJM. Results show that the age of PJM acquisition has a significant impact on performance on this task. The earlier deaf people acquire PJM, the more likely they were to distinguish signs and sentences considered permissible and impermissible in PJM by native signers. Native signers had significantly greater accuracy on the phonological, morphological, and syntactic items than either the Childhood or the Adolescent signers. Further, the Childhood signers had significantly greater accuracy than the Adolescent signers on all three parts of the test. Comparing performance on specific structures targeted within each part of the test revealed that multi-channel signs and negative suffixes posed the greatest challenge for Adolescent signers relative to the Native signers. The above results provide evidence from a less-commonly studied signed language that the age of onset of first language acquisition affects ultimate outcomes in language acquisition across all levels of grammatical structure. In addition, this research corroborates prior studies demonstrating that the critical period is independent of language modality. Contrary to a common public health assumption that early exposure to language is less vital to signed than to spoken language development, the results of this study demonstrate that early exposure to a signed language promotes sensitivity to phonological, morphological and syntactic patterns in language.

Number Stroop Effects in Arabic Digits and ASL Number Signs: The Impact of Age and Setting of Language Acquisition

Multiple studies have reported mathematics underachievement for students who are deaf, but the onset, scope, and causes of this phenomenon remain understudied. Early language deprivation might be one factor influencing the acquisition of numbers. In this study, we investigated a basic and fundamental mathematical skill, automatic magnitude processing, in two formats (Arabic digits and American Sign Language number signs) and the influence of age of first language exposure on both formats by using two versions of the Number Stroop Test. We compared the performance of individuals born deaf who experienced early language deprivation to that of individuals born deaf who experienced sign language in early life and hearing second language learners of ASL. In both formats of magnitude representation, late first language learners demonstrated overall slower reaction times. They were also less accurate on incongruent trials but performed no differently from early signers and second language learners on other trials. When magnitude was represented by Arabic digits, late first language learners exhibited robust Number Stroop Effects, suggesting automatic magnitude processing, but they also demonstrated a large speed difference between size and number judgments not observed in the other groups. In a task with ASL number signs, the Number Stroop Effect was not found in any group, suggesting that magnitude representation might be format-specific, in line with the results from several other languages. Late first language learners also demonstrate unusual patterns of slower reaction time for neutral rather than incongruent stimuli. Together, the results show that early language deprivation affects the ability to automatically judge quantities expressed both linguistically and by Arabic digits, but that it can be acquired later in life when language is available. Contrary to previous studies that find differences in speed of number processing between deaf and hearing participants, we find that when language is acquired early in life, deaf signers perform identically to hearing participants.

Brain Morphological Modifications in Congenital and Acquired Auditory Deprivation: A Systematic Review and Coordinate-Based Meta-Analysis

Neuroplasticity following deafness has been widely demonstrated in both humans and animals, but the anatomical substrate of these changes is not yet clear in human brain. However, it is of high importance since hearing loss is a growing problem due to aging population. Moreover, knowing these brain changes could help to understand some disappointing results with cochlear implant, and therefore could improve hearing rehabilitation. A systematic review and a coordinate-based meta-analysis were realized about the morphological brain changes highlighted by MRI in severe to profound hearing loss, congenital and acquired before or after language onset. 25 papers were included in our review, concerning more than 400 deaf subjects, most of them presenting prelingual deafness. The most consistent finding is a volumetric decrease in gray matter around bilateral auditory cortex. This change was confirmed by the coordinate-based meta-analysis which shows three converging clusters in this region. The visual areas of deaf children is also significantly impacted, with a decrease of the volume of both gray and white matters. Finally, deafness is responsible of a gray matter increase within the cerebellum, especially at the right side. These results are largely discussed and compared with those from deaf animal models and blind humans, which demonstrate for example a much more consistent gray matter decrease along their respective primary sensory pathway. In human deafness, a lot of other factors than deafness could interact on the brain plasticity. One of the most important is the use of sign language and its age of acquisition, which induce among others changes within the hand motor region and the visual cortex. But other confounding factors exist which have been too little considered in the current literature, such as the etiology of the hearing impairment, the speech-reading ability, the hearing aid use, the frequent associated vestibular dysfunction or neurocognitive impairment. Another important weakness highlighted by this review concern the lack of papers about postlingual deafness, whereas it represents most of the deaf population. Further studies are needed to better understand these issues, and finally try to improve deafness rehabilitation.

Associations Between Sign Language Skills and Resting-State Functional Connectivity in Deaf Early Signers

The processing of a language involves a neural language network including temporal, parietal, and frontal cortical regions. This applies to spoken as well as signed languages. Previous research suggests that spoken language proficiency is associated with resting-state functional connectivity (rsFC) between language regions and other regions of the brain. Given the similarities in neural activation for spoken and signed languages, rsFC-behavior associations should also exist for sign language tasks. In this study, we explored the associations between rsFC and two types of linguistic skills in sign language: phonological processing skill and accuracy in elicited sentence production. Fifteen adult, deaf early signers were enrolled in a resting-state functional magnetic resonance imaging (fMRI) study. In addition to fMRI data, behavioral tests of sign language phonological processing and sentence reproduction were administered. Using seed-to-voxel connectivity analysis, we investigated associations between behavioral proficiency and rsFC from language-relevant nodes: bilateral inferior frontal gyrus (IFG) and posterior superior temporal gyrus (STG). Results showed that worse sentence processing skill was associated with stronger positive rsFC between the left IFG and left sensorimotor regions. Further, sign language phonological processing skill was associated with positive rsFC from right IFG to middle frontal gyrus/frontal pole although this association could possibly be explained by domain-general cognitive functions. Our findings suggest a possible connection between rsFC and developmental language outcomes in deaf individuals.

The Spoken Language Checklist: A User-Friendly Normed Language Acquisition Checklist

There are many variables having an impact on the spoken language acquisition of deaf and hard of hearing (DHH) children; therefore, it is critical for parents and professionals to have appropriate tools to monitor language acquisition. The Spoken Language Checklist (SLC) was developed to monitor and identify developmental milestones in a user-friendly checklist format that includes norms. The availability of the SLC will help parents and professionals to monitor the spoken language development of DHH children and provide interventions that should any delays be observed. Recognizing these delays early could prevent any insurmountable effects for cognitive development and further language development.

A Whole-Cortex Probabilistic Diffusion Tractography Connectome

The WU-Minn Human Connectome Project (HCP) is a publicly-available dataset containing state-of-the-art structural magnetic resonance imaging (MRI), functional MRI (fMRI), and diffusion MRI (dMRI) for over a thousand healthy subjects. While the planned scope of the HCP included an anatomic connectome, resting-state fMRI (rs-fMRI) forms the bulk of the HCP's current connectomic output. We address this by presenting a full-cortex connectome derived from probabilistic diffusion tractography and organized into the HCP-MMP1.0 atlas. Probabilistic methods and large sample sizes are preferable for whole-connectome mapping as they increase the fidelity of traced low-probability connections. We find that overall, connection strengths are lognormally distributed and decay exponentially with tract length, that connectivity reasonably matches macaque histologic tracing in homologous areas, that contralateral homologs and left-lateralized language areas are hyperconnected, and that hierarchical similarity influences connectivity. We compare the dMRI connectome to existing rs-fMRI and cortico-cortico-evoked potential connectivity matrices and find that it is more similar to the latter. This work helps fulfill the promise of the HCP and will make possible comparisons between the underlying structural connectome and functional connectomes of various modalities, brain states, and clinical conditions.

The neurocognitive basis of skilled reading in prelingually and profoundly deaf adults

Deaf individuals have unique sensory and linguistic experiences that influence how they read and become skilled readers. This review presents our current understanding of the neurocognitive underpinnings of reading skill in deaf adults. Key behavioural and neuroimaging studies are integrated to build a profile of skilled adult deaf readers and to examine how changes in visual attention and reduced access to auditory input and phonology shape how they read both words and sentences. Crucially, the behaviours, processes, and neural circuity of deaf readers are compared to those of hearing readers with similar reading ability to help identify alternative pathways to reading success. Overall, sensitivity to orthographic and semantic information is comparable for skilled deaf and hearing readers, but deaf readers rely less on phonology and show greater engagement of the right hemisphere in visual word processing. During sentence reading, deaf readers process visual word forms more efficiently and may have a greater reliance on and altered connectivity to semantic information compared to their hearing peers. These findings highlight the plasticity of the reading system and point to alternative pathways to reading success.

A Whole-Cortex Probabilistic Diffusion Tractography Connectome

The WU-Minn Human Connectome Project (HCP) is a publicly-available dataset containing state-of-the-art structural magnetic resonance imaging (MRI), functional MRI (fMRI), and diffusion MRI (dMRI) for over a thousand healthy subjects. While the planned scope of the HCP included an anatomic connectome, resting-state fMRI (rs-fMRI) forms the bulk of the HCP's current connectomic output. We address this by presenting a full-cortex connectome derived from probabilistic diffusion tractography and organized into the HCP-MMP1.0 atlas. Probabilistic methods and large sample sizes are preferable for whole-connectome mapping as they increase the fidelity of traced low-probability connections. We find that overall, connection strengths are lognormally distributed and decay exponentially with tract length, that connectivity reasonably matches macaque histologic tracing in homologous areas, that contralateral homologs and left-lateralized language areas are hyperconnected, and that hierarchical similarity influences connectivity. We compare the dMRI connectome to existing rs-fMRI and cortico-cortico-evoked potential connectivity matrices and find that it is more similar to the latter. This work helps fulfill the promise of the HCP and will make possible comparisons between the underlying structural connectome and functional connectomes of various modalities, brain states, and clinical conditions.

Novel Prefrontal Synthesis Intervention Improves Language in Children with Autism

Prefrontal synthesis (PFS) is defined as the ability to juxtapose mental visuospatial objects at will. Paralysis of PFS may be responsible for the lack of comprehension of spatial prepositions, semantically-reversible sentences, and recursive sentences observed in 30 to 40% of individuals with autism spectrum disorder (ASD). In this report we present data from a three-year-long clinical trial of 6454 ASD children age 2 to 12 years, which were administered a PFS-targeting intervention. Tablet-based verbal and nonverbal exercises emphasizing mental-juxtaposition-of-objects were organized into an application called Mental Imagery Therapy for Autism (MITA). The test group included participants who completed more than one thousand exercises and made no more than one error per exercise. The control group was selected from the rest of participants by a matching procedure. Each test group participant was matched to the control group participant by age, gender, expressive language, receptive language, sociability, cognitive awareness, and health score at first evaluation using propensity score analysis. The test group showed a 2.2-fold improvement in receptive language score vs. control group (p < 0.0001) and a 1.4-fold improvement in expressive language (p = 0.0144). No statistically significant change was detected in other subscales not targeted by the exercises. These findings show that language acquisition improves after training PFS and that a further investigation of the PFS-targeting intervention in a randomized controlled study is warranted.

Computer code comprehension shares neural resources with formal logical inference in the fronto-parietal network

Despite the importance of programming to modern society, the cognitive and neural bases of code comprehension are largely unknown. Programming languages might 'recycle' neurocognitive mechanisms originally developed for natural languages. Alternatively, comprehension of code could depend on fronto-parietal networks shared with other culturally-invented symbol systems, such as formal logic and symbolic math such as algebra. Expert programmers (average 11 years of programming experience) performed code comprehension and memory control tasks while undergoing fMRI. The same participants also performed formal logic, symbolic math, executive control, and language localizer tasks. A left-lateralized fronto-parietal network was recruited for code comprehension. Patterns of activity within this network distinguish between 'for' loops and 'if' conditional code functions. In terms of the underlying neural basis, code comprehension overlapped extensively with formal logic and to a lesser degree math. Overlap with executive processes and language was low, but laterality of language and code covaried across individuals. Cultural symbol systems, including code, depend on a distinctive fronto-parietal cortical network.

When event knowledge overrides word order in sentence comprehension: Learning a first language after childhood

Limited language experience in childhood is common among deaf individuals, which prior research has shown to lead to low levels of language processing. Although basic structures such as word order have been found to be resilient to conditions of sparse language input in early life, whether they are robust to conditions of extreme language delay is unknown. The sentence comprehension strategies of post-childhood, first-language (L1) learners of American Sign Language (ASL) with at least 9 years of language experience were investigated, in comparison to two control groups of learners with full access to language from birth (deaf native signers and hearing L2 learners who were native English speakers). The results of a sentence-to-picture matching experiment show that event knowledge overrides word order for post-childhood L1 learners, regardless of the animacy of the subject, while both deaf native signers and hearing L2 signers consistently rely on word order to comprehend sentences. Language inaccessibility throughout early childhood impedes the acquisition of even basic word order. Similar to the strategies used by very young children prior to the development of basic sentence structure, post-childhood L1 learners rely more on context and event knowledge to comprehend sentences. Language experience during childhood is critical to the development of basic sentence structure.

Sensitive periods in cortical specialization for language: insights from studies with Deaf and blind individuals

Studies with Deaf and blind individuals demonstrate that linguistic and sensory experiences during sensitive periods have potent effects on neurocognitive basis of language. Native users of sign and spoken languages recruit similar fronto-temporal systems during language processing. By contrast, delays in sign language access impact proficiency and the neural basis of language. Analogously, early but not late-onset blindness modifies the neural basis of language. People born blind recruit 'visual' areas during language processing, show reduced left-lateralization of language and enhanced performance on some language tasks. Sensitive period plasticity in and outside fronto-temporal language systems shapes the neural basis of language.

Effects of ASL Rhyme and Rhythm on Deaf Children's Engagement Behavior and Accuracy in Recitation: Evidence from a Single Case Design

Early language acquisition is critical for lifelong success in language, literacy, and academic studies. There is much to explore about the specific techniques used to foster deaf children’s language development. The use of rhyme and rhythm in American Sign Language (ASL) remains understudied. This single-subject study compared the effects of rhyming and non-rhyming ASL stories on the engagement behavior and accuracy in recitation of five deaf children between three and six years old in an ASL/English bilingual early childhood classroom. With the application of alternating treatment design with initial baseline, it is the first experimental research of its kind on ASL rhyme and rhythm. Baseline data revealed the lack of rhyme awareness in children and informed the decision to provide intervention as a condition to examine the effects of explicit handshape rhyme awareness instruction on increasing engagement behavior and accuracy in recitation. There were four phases in this study: baseline, handshape rhyme awareness intervention, alternating treatments, and preference. Visual analysis and total mean and mean difference procedures were employed to analyze results. The findings indicate that recitation skills in young deaf children can be supported through interventions utilizing ASL rhyme and rhythm supplemented with ASL phonological awareness activities. A potential case of sign language impairment was identified in a native signer, creating a new line of inquiry in using ASL rhyme, rhythm, and phonological awareness to detect atypical language patterns.

Structural neuroimaging of the altered brain stemming from pediatric and adolescent hearing loss-Scientific and clinical challenges

There has been a spurt in structural neuroimaging studies of the effect of hearing loss on the brain. Specifically, magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) technologies provide an opportunity to quantify changes in gray and white matter structures at the macroscopic scale. To date, there have been 32 MRI and 23 DTI studies that have analyzed structural differences accruing from pre- or peri-lingual pediatric hearing loss with congenital or early onset etiology and postlingual hearing loss in pre-to-late adolescence. Additionally, there have been 15 prospective clinical structural neuroimaging studies of children and adolescents being evaluated for cochlear implants. The results of the 70 studies are summarized in two figures and three tables. Plastic changes in the brain are seen to be multifocal rather than diffuse, that is, differences are consistent across regions implicated in the hearing, speech and language networks regardless of modes of communication and amplification. Structures in that play an important role in cognition are affected to a lesser extent. A limitation of these studies is the emphasis on volumetric measures and on homogeneous groups of subjects with hearing loss. It is suggested that additional measures of morphometry and connectivity could contribute to a greater understanding of the effect of hearing loss on the brain. Then an interpretation of the observed macroscopic structural differences is given. This is followed by discussion of how structural imaging can be combined with functional imaging to provide biomarkers for longitudinal tracking of amplification. This article is categorized under: Developmental Biology > Developmental Processes in Health and Disease Translational, Genomic, and Systems Medicine > Translational Medicine Laboratory Methods and Technologies > Imaging.

Rethinking the critical period for language: New insights into an old question from American Sign Language

We thank the commentators for their thoughtful critiques, which we found both insightful and stimulating to our own thinking. Our first response is that, while debates about the CPL in theoretical contexts are important, the vigor and intensity of these debates should not overshadow the fact that the main goal of our article was to highlight a finding of vital importance: Sufficient language input in early childhood matters deeply because it has long-term consequences (Lillo-Martin, 2018). Woll sums up this point both succinctly and poignantly in her report of a similar case of very late L1 exposure in adulthood who had decades of experience: “For a [deaf] child who, even in the context of early intervention, does not acquire a spoken language, the danger is that they will never have native-like mastery of any L1.” This is what truly matters. Our hope is that our keynote article and the accompanying commentaries might have a positive effect on clinical practice, educational policy, and even parental choice in this regard. In what follows, we discuss the main issues arising from the commentaries. First we note the points of agreement followed by a clarification of what we did not claim in our article. Researchers continue to debate what the shape of the AoA function looks like and its theoretical implications, which we address third. We then address the issues raised as to whether late L1 acquisition and late L2 learning differ in degree or kind, and last we discuss what we mean when we say that language acquisition during post-natal brain growth creates the capacity to learn language.