Deaf children's non-verbal working memory is impacted by their language experience

Exposure to sign language prior and after cochlear implantation increases language and cognitive skills in deaf children

Recent evidence suggests that deaf children with CIs exposed to nonnative sign language from hearing parents can attain age-appropriate vocabularies in both sign and spoken language. It remains to be explored whether deaf children with CIs who are exposed to early nonnative sign language, but only up to implantation, also benefit from this input and whether these benefits also extend to memory abilities, which are strongly linked to language development. The present study examined the impact of deaf children's early short-term exposure to nonnative sign input on their spoken language and their phonological memory abilities. Deaf children who had been exposed to nonnative sign input before and after cochlear implantation were compared to deaf children who never had any exposure to sign input as well as to children with typical hearing. The children were between 5;1 and 7;1 years of age at the time of testing and were matched on age, sex, and socioeconomic status. The results suggest that even short-term exposure to nonnative sign input has positive effects on general language and phonological memory abilities as well as on nonverbal working memory-with total length of exposure to sign input being the best predictor of deaf children's performance on these measures. The present data suggest that even access to early short-term nonnative visual language input is beneficial for the language and phonological memory abilities of deaf children with cochlear implants, suggesting also that parents should not be discouraged from learning and exposing their child to sign language. RESEARCH HIGHLIGHTS: This is the first study to examine the effects of early short-term exposure to nonnative sign input on French-speaking children with cochlear implants' spoken language and memory abilities. Early short-term nonnative exposure to sign input can have positive consequences for the language and phonological memory abilities of deaf children with CIs. Extended exposure to sign input has some additional and important benefits, allowing children to perform on par with children with typical hearing.

Written Language Characteristics of Deaf and Hard of Hearing Students in Terms of the Components of the Language

Hearing has vital importance for language development. Deaf and hard of hearing children have problems in spoken and written language due to hearing loss. The development of written language is directly related to language skills such as listening, speaking, and reading skills. This study aims to evaluate the use of language components in written language in deaf and hard of hearing students. In the study, writing samples of eight deaf and hard of hearing students who continue 4th grade in the school for the deaf were taken and error analysis was conducted. Besides, interviews were made with their classroom teacher about their language development, and in-class observations were conducted. It was seen as a result of the study that deaf and hard of hearing students have significant difficulties in all components of language in written language.

Verbal and visual serial-order memory in deaf signers and hearing nonsigners: A systematic review and meta-analysis

Previous research suggests Deaf signers may have different short-term and working memory processes compared with hearing nonsigners due to prolonged auditory deprivation. The direction and magnitude of these reported differences, however, are variable and dependent on memory modality (e.g., visual, verbal), stimulus type, and research design. These discrepancies have made consensus difficult to reach which, in turn, slows progress in areas such as education, medical decision-making, and cognitive sciences. The present systematic review and meta-analysis included 35 studies (N = 1,701 participants) that examined verbal (n = 15), visuospatial (n = 10), or both verbal and visuospatial (n = 10) serial-memory tasks comparing nonimplanted, Deaf signers to hearing nonsigners across the life span. Multivariate meta-analyses indicated a significant, negative effect of deafness on verbal short-term memory (forward recall), g = -1.33, SE = 0.17, p < .001, 95% CI [-1.68, -0.98], and working memory (backward recall), g = -0.66, SE = 0.11, p < .001, 95% CI [-0.89, -0.45], but no significant effect of deafness on visuospatial short-term memory, g = -0.055, SE = 0.17, p = 0.75, 95% CI [-0.39, 0.28]. Visuospatial working memory was not analyzed due to limited power. Population estimates for verbal and visuospatial short-term memory were moderated by age wherein studies with adults demonstrated a stronger hearing advantage than studies with children/adolescents. Quality estimates indicated most studies were of fair quality, with only 38% of studies involving Deaf authors. Findings are discussed in the context of both Deaf equity and models of serial memory.

Specific Language Impairment and Executive Functions in School-Age Children: A Systematic Review

This systematic review examines the relationship between specific language impairment (SLI) and executive functions (EFs) in school-age children. The study investigates the impact of SLI on EF in comparison to children who develop normally. A total of 2,658 articles from three databases (PubMed, Scopus, and Virtual Health Library) were assessed for inclusion. Ultimately, 22 articles were selected for analysis, which contained information on both SLI and EF. The findings indicate that children diagnosed with SLI exhibit deficits, low performance, and, in some cases, significant deterioration in the development of EF when compared to typically developing children in 62%-91% of cases as early as three to four years of age; the most commonly found alterations were in working memory (including phonological, auditory, and visual/verbal memory), followed by deficits in attention, processing speed, inhibition, planning, cognitive flexibility, and internalized speech. We also discuss the close relationship and importance between language and EF in SLI children.

Executive Function in Deaf Native Signing Children

The aim of this study is twofold: To examine if deafness is invariably associated with deficits in executive function (EF) and to investigate the relationship between sign language proficiency and EF in deaf children of deaf parents with early exposure to a sign language. It is also the first study of EF in children acquiring Polish Sign Language. Even though the mothers of the deaf children (N = 20) had lower levels of education compared with the mothers of a hearing control group, the children performed similarly to their hearing peers (N = 20) on a variety of EF task-based assessments. Only in the Go/No-go task were weaker inhibition skills observed in younger deaf children (6-9 years) compared with hearing peers, and this difference was not seen in older children (10-12 years). Hence, deafness does not necessarily impair EF; however, attentional and inhibition abilities may be acquired via a different route in deaf children. Sign language receptive skills predicted EF in deaf children. In conclusion, we highlight the importance of deaf parenting building the scaffolding for EF in deaf children.

Late sign language exposure does not modulate the relation between spatial language and spatial memory in deaf children and adults

Prior work with hearing children acquiring a spoken language as their first language shows that spatial language and cognition are related systems and spatial language use predicts spatial memory. Here, we further investigate the extent of this relationship in signing deaf children and adults and ask if late sign language exposure, as well as the frequency and the type of spatial language use that might be affected by late exposure, modulate subsequent memory for spatial relations. To do so, we compared spatial language and memory of 8-year-old late-signing children (after 2 years of exposure to a sign language at the school for the deaf) and late-signing adults to their native-signing counterparts. We elicited picture descriptions of Left-Right relations in Turkish Sign Language (Türk İşaret Dili) and measured the subsequent recognition memory accuracy of the described pictures. Results showed that late-signing adults and children were similar to their native-signing counterparts in how often they encoded the spatial relation. However, late-signing adults but not children differed from their native-signing counterparts in the type of spatial language they used. However, neither late sign language exposure nor the frequency and type of spatial language use modulated spatial memory accuracy. Therefore, even though late language exposure seems to influence the type of spatial language use, this does not predict subsequent memory for spatial relations. We discuss the implications of these findings based on the theories concerning the correspondence between spatial language and cognition as related or rather independent systems.

Effect of visual presentation format and recall direction on letter span and error patterns in Deaf signing and hearing adults

Deaf signers consistently show shorter memory spans than hearing nonsigners, but the scope and nature of this difference remain unclear. The present study tested whether Deaf signers are biased toward flexible use of visual aspects of linguistic items. Matched samples of adult Deaf signers (N = 33) and hearing nonsigners (N = 32) performed a letter-span task with visual serial presentation, to bias phonological processing, and a simultaneous presentation, to bias visuospatial processing. We also manipulated short-term memory by varying recall direction (forward, backward). Analyses revealed reduced spans for Deaf signers compared with hearing nonsigners, backward compared with forward recall, and sequential compared with simultaneous presentation. Item-level responses indicated that Deaf signers made more errors than hearing nonsigners across three error types. Deaf signers also showed reduced item position binding compared with hearing nonsigners, which indicates differences related to item order and sequencing in tasks with printed, linguistic stimuli. Deaf signers were the only group who demonstrated reduced omission errors when switching from sequential to simultaneous presentation, suggesting flexible processing mechanisms. No group differences were found for a secondary spatial span test, indicating the scope of group differences for ordered information was limited to verbal items. Overall, results are consistent with flexible use of different memory cues in Deaf signers. A core area for future research includes evaluating reduced activation of phonological representations of linguistic items in Deaf signers. These results amplify a novel M³ model approach for evaluating how errors contribute to short-term memory differences in Deaf signers.

Sign advantage: Both children and adults' spatial expressions in sign are more informative than those in speech and gestures combined

Expressing Left-Right relations is challenging for speaking-children. Yet, this challenge was absent for signing-children, possibly due to iconicity in the visual-spatial modality of expression. We investigate whether there is also a modality advantage when speaking-children's co-speech gestures are considered. Eight-year-old child and adult hearing monolingual Turkish speakers and deaf signers of Turkish-Sign-Language described pictures of objects in various spatial relations. Descriptions were coded for informativeness in speech, sign, and speech-gesture combinations for encoding Left-Right relations. The use of co-speech gestures increased the informativeness of speakers' spatial expressions compared to speech-only. This pattern was more prominent for children than adults. However, signing-adults and children were more informative than child and adult speakers even when co-speech gestures were considered. Thus, both speaking- and signing-children benefit from iconic expressions in visual modality. Finally, in each modality, children were less informative than adults, pointing to the challenge of this spatial domain in development.

Phoneme Categorization in Prelingually Deaf Adult Cochlear Implant Users

PURPOSE

Phoneme categorization (PC) for voice onset time and second formant transition was studied in adult cochlear implant (CI) users with early-onset deafness and hearing controls.

METHOD

Identification and discrimination tasks were administered to 30 participants implanted before 4 years of age, 21 participants implanted after 7 years of age, and 21 hearing individuals.

RESULTS

Distinctive identification and discrimination functions confirmed PC within all groups. Compared to hearing participants, the CI groups generally displayed longer/higher category boundaries, shallower identification function slopes, reduced identification consistency, and reduced discrimination performance. A principal component analysis revealed that identification consistency, discrimination accuracy, and identification function slope, but not boundary location, loaded on a single factor, reflecting general PC performance. Earlier implantation was associated with better PC performance within the early CI group, but not the late CI group. Within the early CI group, earlier implantation age but not PC performance was associated with better speech recognition. Conversely, within the late CI group, better PC performance but not earlier implantation age was associated with better speech recognition.

CONCLUSIONS

Results suggest that implantation timing within the sensitive period before 4 years of age partly determines the level of PC performance. They also suggest that early implantation may promote development of higher level processes that can compensate for relatively poor PC performance, as can occur in challenging listening conditions.

Under-resourced or overloaded? Rethinking working memory deficits in developmental language disorder

Dominant theoretical accounts of developmental language disorder (DLD) commonly invoke working memory capacity limitations. In the current report, we present an alternative view: That working memory in DLD is not under-resourced but overloaded due to operating on speech representations with low discriminability. This account is developed through computational simulations involving deep convolutional neural networks trained on spoken word spectrograms in which information is either retained to mimic typical development or degraded to mimic the auditory processing deficits identified among some children with DLD. We assess not only spoken word recognition accuracy and predictive probability and entropy (i.e., predictive distribution spread), but also use mean-field-theory based manifold analysis to assess; (a) internal speech representation dimensionality and (b) classification capacity, a measure of the networks' ability to isolate any given internal speech representation that is used as a proxy for attentional control. We show that instantiating a low-level auditory processing deficit results in the formation of internal speech representations with atypically high dimensionality, and that classification capacity is exhausted due to low representation separability. These representation and control deficits underpin not only lower performance accuracy but also greater uncertainty even when making accurate predictions in a simulated spoken word recognition task (i.e., predictive distributions with low maximum probability and high entropy), which replicates the response delays and word finding difficulties often seen in DLD. Overall, these simulations demonstrate a theoretical account of speech representation and processing deficits in DLD in which working memory capacity limitations play no causal role. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Deaf Children Need Rich Language Input from the Start: Support in Advising Parents

Bilingual bimodalism is a great benefit to deaf children at home and in schooling. Deaf signing children perform better overall than non-signing deaf children, regardless of whether they use a cochlear implant. Raising a deaf child in a speech-only environment can carry cognitive and psycho-social risks that may have lifelong adverse effects. For children born deaf, or who become deaf in early childhood, we recommend comprehensible multimodal language exposure and engagement in joint activity with parents and friends to assure age-appropriate first-language acquisition. Accessible visual language input should begin as close to birth as possible. Hearing parents will need timely and extensive support; thus, we propose that, upon the birth of a deaf child and through the preschool years, among other things, the family needs an adult deaf presence in the home for several hours every day to be a linguistic model, to guide the family in taking sign language lessons, to show the family how to make spoken language accessible to their deaf child, and to be an encouraging liaison to deaf communities. While such a support program will be complicated and challenging to implement, it is far less costly than the harm of linguistic deprivation.

Working Memory-Based Cognitive Rehabilitation: Spoken Language of Deaf and Hard-of-Hearing Children

This research examined the effect of the Working Memory-based Cognitive Rehabilitation (WMCR) intervention on the spoken language development of deaf and hard-of-hearing (DHH) children. In this clinical trial study, 28 DHH children aged between 5 and 6 years were selected by random sampling method. The participants were randomly assigned to experimental and control groups. The experimental group participated in the WMCR intervention involving 11 sessions. All participants were assessed pre-and postintervention. Data were collected by the Newsha Development Scale and analyzed through MANCOVA. The results revealed a significant difference between the scores of the receptive and expressive language of the experimental group that were exposed to the WMCR intervention compared with the control group. The receptive and expressive language skills of the experimental group indicated a significant improvement after the intervention. Therefore, the WMCR intervention is an effective method that affects the spoken language skills of DHH children. These findings have critical implications for teachers, parents, and therapists in supporting DHH young children to develop their language skills.

Sensory experience modulates the reorganization of auditory regions for executive processing

Crossmodal plasticity refers to the reorganisation of sensory cortices in the absence of their typical main sensory input. Understanding this phenomenon provides insights into brain function and its potential for change and enhancement. Using fMRI, we investigated how early deafness influences crossmodal plasticity and the organisation of executive functions in the adult human brain. Deaf (N = 25; age: mean = 41.68, range = 19-66, SD = 14.38; 16 female, 9 male) and hearing (N = 20; age: mean= 37.50, range= 18-66, SD= 16.85; 15 female, 5 male) participants performed four visual tasks tapping into different components of executive processing: task switching, working memory, planning and inhibition. Our results show that deaf individuals specifically recruit "auditory" regions during task switching. Neural activity in superior temporal regions, most significantly in the right hemisphere, are good predictors of behavioural performance during task switching in the group of deaf individuals, highlighting the functional relevance of the observed cortical reorganisation. Our results show executive processing in typically sensory regions, suggesting that the development and ultimate role of brain regions are influenced by perceptual environmental experience.

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.

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

OBJECTIVE

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

DESIGN

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

RESULTS

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

CONCLUSIONS

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

Language not auditory experience is related to parent-reported executive functioning in preschool-aged deaf and hard-of-hearing children

Much research has found disrupted executive functioning (EF) in deaf and hard‐of‐hearing (DHH) children; while some theories emphasize the role of auditory deprivation, others posit delayed language experience as the primary cause. This study investigated the role of language and auditory experience in parent‐reported EF for 123 preschool‐aged children (M_age = 60.1 months, 53.7% female, 84.6% White). Comparisons between DHH and typically hearing children exposed to language from birth (spoken or signed) showed no significant differences in EF despite drastic differences in auditory input. Linear models demonstrated that earlier language exposure predicted better EF (β = .061–.341), while earlier auditory exposure did not. Few participants exhibited clinically significant executive dysfunction. Results support theories positing that language, not auditory experience, scaffolds EF development.

Measuring Receptive ASL Skills in Novice Signers and Nonsigners

We tested the utility of two standardized measures of receptive skills in American Sign Language (ASL) in hearing adults who are novice signers: the ASL Comprehension Test (ASL-CT; Hauser, P. C., Paludneviciene, R., Riddle, W., Kurz, K. B., Emmorey, K., & Contreras, J. (2016). American Sign Language Comprehension Test: A tool for sign language researchers. Journal of Deaf Studies and Deaf Education, 21(1), 64-69. https://doi.org/10.1093/deafed/env051) and the ASL Receptive Skills Test (ASL-RST; Allen, T. E., & Enns, C. (2013). A psychometric study of the ASL Receptive Skills Test when administered to deaf 3-, 4-, and 5-year-old children. Sign Language Studies, 14(1), 58-79. https://doi.org/10.1353/sls.2015.0006; Enns, C. J., & Herman, R. C. (2011). Adapting the Assessing British Sign Language Development: Receptive Skills Test into American Sign Language. Journal of Deaf Studies and Deaf Education, 16(3), 362-374. https://doi.org/10.1093/deafed/enr004). We also administered these tests to hearing nonsigners, with the goal of identifying items where the correct answer can be readily deduced through iconicity and/or test-taking skills, even by people with no prior ASL knowledge. We predicted that removing such items would strengthen the correlation between test score and ASL experience (as measured by semesters of instruction). We found that this relationship was stronger for the ASL-CT than the ASL-RST in this population, but still weaker than previously reported, and not substantially improved by any item selection strategy that we employed.

Children with hearing impairment and early cochlear implant: A pragmatic assessment

Extensive research has demonstrated the benefits of cochlear implants (CI) in contributing to improve the linguistic skills of children with hearing impairment; however, few studies have focused on the development of pragmatic ability and its relationship with age of implantation. Pragmatics is the ability to use language in different contexts and its development has crucial implications, e.g., social inclusion and professional attainments. In this study, we conducted a comprehensive assessment of pragmatic ability using the Language Pragmatic Abilities (APL Medea), a battery composed by five different tasks: Comprehension of Metaphors, Implicit meaning, Comics, Situations and Colors Game (a perspective taking task). Eighteen children with early CI, belonging to 3 different age groups (6; 11-7; 11, 8; 0-8; 11 and 9; 0-9; 11 years-old), and twenty-four children with typical development (Control Group) participated to the study. We also investigated how the precocity of CI, i.e., age of first implantation, may affect the pragmatic development. Globally, children with CI obtained lower scores in the APL Medea battery than typically hearing children. However, focusing on the Medea tasks separately, children with CIs differed from their hearing peers only in Comics and Colors Game tasks. Finally, age of implantation was a moderate but significant predictor of pragmatic performance.

Visuospatial and Tactile Working Memory in Individuals with Congenital Deafness

Studies examining visuospatial working memory (WM) in individuals with congenital deafness have yielded inconsistent results, and tactile WM has rarely been examined. The current study examined WM span tasks in the two modalities among 20 individuals with congenital deafness and 20 participants with typical hearing. The congenital deafness group had longer forward and backward spans than typical hearing participants in a computerized Corsi block-tapping test (Visuospatial Span), whereas no such difference was found in the Tactual Span (tactile WM). In the congenital deafness group, age of sign language acquisition was not correlated with either condition of the visuospatial task, and Tactual and Visuospatial Spans scores were correlated in the backward but not the forward condition. The typical hearing group showed no correlation between the tasks. The findings suggest that early deafness leads to visuospatial but not tactile superiority in WM, specifically with respect to the storage component. More broadly, it appears that deafness-related compensation mechanisms in WM do not affect the other modalities in a uniform manner.

Visual Sequence Repetition Learning is Not Impaired in Signing DHH Children

The auditory scaffolding hypothesis states that early experience with sound underpins the development of domain-general sequence processing abilities, supported by studies observing impaired sequence processing in deaf or hard-of-hearing (DHH) children. To test this hypothesis, we administered a sequence processing task to 77 DHH children who use American Sign Language (ASL) and 23 hearing monolingual children aged 7-12 years and found no performance difference between them after controlling for age and nonverbal intelligence. Additionally, neither spoken language comprehension scores nor hearing loss levels predicted sequence processing scores in the DHH group, whereas ASL comprehension scores did. Our results do not indicate sequence processing deficits in DHH children and do not support the auditory scaffolding hypothesis; instead, these findings suggest that factors related to experience with and/or proficiency in an accessible language during development may be more important determinants of sequence processing abilities.

The interplay between early social interaction, language and executive function development in deaf and hearing infants

In this article, we review the influence of early social interaction on the development of executive function and language in infants. We first define social interaction, executive function and language and show how they are related in infant development. Studies of children born deaf are used to illustrate this connection because they represent cases where there has been a disruption to early social interaction and the development of intersubjectivity. Unlike other groups, the disturbance to development is known to be largely environmental rather than neuro-biological. This enables us to more accurately tease apart those impacts on EF that are associated with social interaction and language, since the potential confounds of disordered cognitive development are largely controlled for. The review offers a unifying model for how social, cognitive and linguistic development work together in early human development.

Cross-modal plasticity and central deficiencies: the case of deafness and the use of cochlear implants

The primary objective of this chapter is to describe the consequences of central deficiencies on the neurodevelopment of children. We approach this topic from the standpoint of congenital deafness. Thus we first present the current state of knowledge on cortical reorganization following congenital deafness. The allocation of auditory cortices to other sensory systems can enhance sensory processing and therefore the cognitive functions related to them. Second, we explore the linguistic development of deaf children. Given that the English written system is speech-based, its acquisition is complex and atypical for deaf children, usually leading to poorer achievements. Next, we explore the impact of a neural prosthesis named the cochlear implant on the neurocognitive and linguistic development of deaf children. In some cases, it allows the individuals to, at least partially, regain access to the lost sense. We also comment on the specific needs of the deaf population when it comes to neuropsychological assessment. Finally, we touch on the specific context of deaf children born of deaf parents, and therefore naturally exposed to sign language as the only means of communication.

Written Language Outcomes of Deaf Elementary Students Engaged in Authentic Writing

This study explores the impact of Strategic and Interactive Writing Instruction (SIWI) on six students' written language skills through the application of a multiple-baseline probe single case design with embedded condition. This was part of a larger Institute of Education Sciences (IES)-funded project focused on the development and feasibility of implementation of SIWI. For the majority of skills analyzed, there were improvements in the mean level of performance with the implementation of SIWI, as well as more consistent responding and positive trends in the data. The study also revealed that teachers are in need of additional tools to aid the systematic identification and tracking of syntax skills in children's written language development, and to distinguish these from other writing skills such as conventions or handwriting.

Deaf Children as ‘English Learners’: The Psycholinguistic Turn in Deaf Education

The purpose of this literature review is to present the arguments in support of conceptualizing deaf children as ‘English Learners’, to explore the educational implications of such conceptualizations, and to suggest directions for future inquiry. Three ways of interpreting the label ‘English Learner’ in relationship to deaf children are explored: (1) as applied to deaf children whose native language is American Sign Language; (2) as applied to deaf children whose parents speak a language other than English; and (3) as applied to deaf children who have limited access to the spoken English used by their parents. Recent research from the fields of linguistics and neuroscience on the effects of language deprivation is presented and conceptualized within a framework that we refer to as the psycholinguistic turn in deaf education. The implications for developing the literacy skills of signing deaf children are explored, particularly around the theoretical construct of a ‘bridge’ between sign language proficiency and print-based literacy. Finally, promising directions for future inquiry are presented.

Understanding Theory of Mind in Deaf and Hearing College Students

Theory of Mind-the understanding that people have thoughts, wants, and beliefs that influence their interpersonal behavior-is an aspect of social cognition that develops with consistent, increasing complexity across age groups, languages, and cultures. Observed delays in theory of mind development among deaf children and others has led to a conversational account of theory of mind development and its delays in terms of the nature and amount of social communication experienced by children directly (conversationally) and indirectly (via overhearing). The present study explored theory of mind in deaf young adults by evaluating their understanding of sarcasm and advanced false belief (second-order false belief and double bluff), as well as related cognitive abilities. Consistent with previous studies, deaf participants scored significantly below hearing peers on all three theory of mind tasks. Performance was unrelated to their having had early access to social communication via either sign language (from deaf parents) or spoken language (through cochlear implants), suggesting that deaf participants' performance was not solely a function of access to social communication in early childhood. The finding of different predictors of theory of mind performance for deaf and hearing groups is discussed in terms of its language, social, and cognitive foundations.

Expressive Vocabulary Predicts Nonverbal Executive Function: A 2-year Longitudinal Study of Deaf and Hearing Children

Numerous studies suggest an association between language and executive function (EF), but evidence of a developmental relationship remains inconclusive. Data were collected from 75 deaf/hard-of-hearing (DHH) children and 82 hearing age-matched controls. Children were 6-11 years old at first time of testing and completed a battery of nonverbal EF tasks and a test of expressive vocabulary. These tasks were completed again 2 years later. Both groups improved their scores on all tasks over this period. DHH children performed significantly less well than hearing peers on some EF tasks and the vocabulary test at both time points. Cross-lagged panel models showed that vocabulary at Time 1 predicted change in EF scores for both DHH and hearing children but not the reverse.

Considering parental hearing status as a social determinant of deaf population health: Insights from experiences of the "dinner table syndrome"

The influence of early language and communication experiences on lifelong health outcomes is receiving increased public health attention. Most deaf children have non-signing hearing parents, and are at risk for not experiencing fully accessible language environments, a possible factor underlying known deaf population health disparities. Childhood indirect family communication–such as spontaneous conversations and listening in the routine family environment (e.g. family meals, recreation, car rides)–is an important source of health-related contextual learning opportunities. The goal of this study was to assess the influence of parental hearing status on deaf people’s recalled access to childhood indirect family communication. We analyzed data from the Rochester Deaf Health Survey–2013 (n = 211 deaf adults) for associations between sociodemographic factors including parental hearing status, and recalled access to childhood indirect family communication. Parental hearing status predicted deaf adults’ recalled access to childhood indirect family communication (χ² = 31.939, p < .001). The likelihood of deaf adults reporting “sometimes to never” for recalled comprehension of childhood family indirect communication increased by 17.6 times for those with hearing parents. No other sociodemographic or deaf-specific factors in this study predicted deaf adults’ access to childhood indirect family communication. This study finds that deaf people who have hearing parents were more likely to report limited access to contextual learning opportunities during childhood. Parental hearing status and early childhood language experiences, therefore, require further investigation as possible social determinants of health to develop interventions that improve lifelong health and social outcomes of the underserved deaf population.

Executive Function in Deaf Children: Auditory Access and Language Access

Purpose

Deaf children are frequently reported to be at risk for difficulties in executive function (EF); however, the literature is divided over whether these difficulties are the result of deafness itself or of delays/deficits in language that often co-occur with deafness. The purpose of this study is to discriminate these hypotheses by assessing EF in populations where the 2 accounts make contrasting predictions.

Method

We use a between-groups design involving 116 children, ages 5-12 years, across 3 groups: (a) participants with normal hearing (n = 45), (b) deaf native signers who had access to American Sign Language from birth (n = 45), and (c) oral cochlear implant users who did not have full access to language prior to cochlear implantation (n = 26). Measures include both parent report and performance-based assessments of EF.

Results

Parent report results suggest that early access to language has a stronger impact on EF than early access to sound. Performance-based results trended in a similar direction, but no between-group differences were significant.

Conclusions

These results indicate that healthy EF skills do not require audition and therefore that difficulties in this domain do not result primarily from a lack of auditory experience. Instead, results are consistent with the hypothesis that language proficiency, whether in sign or speech, is crucial for the development of healthy EF. Further research is needed to test whether sign language proficiency also confers benefits to deaf children from hearing families.

Attention to speech and spoken language development in deaf children with cochlear implants: a 10-year longitudinal study

Early auditory/language experience plays an important role in language development. In this study, we examined the effects of severe-to-profound hearing loss and subsequent cochlear implantation on the development of attention to speech in children with cochlear implants (CIs). In addition, we investigated the extent to which attention to speech may predict spoken language development in children with CIs. We tested children with CIs and compared them to chronologically age-matched peers with normal hearing (NH) on their attention to speech at four time points post implantation; specifically, less than 1 month, 3 to 6 months, 12 months, and 18 months post implantation. We also collected a variety of well-established speech perception and spoken language measures from the children with CIs in a 10-year longitudinal study. Children with CIs showed reduced attention to speech as compared to their peers with NH at less than 1 month post implantation, but a similar degree of attention to speech as their NH peers during later time points. In addition, attention to speech at 3 to 6 months post implantation predicts speech perception in children with CIs. These results inform language acquisition theories and bring insights into our understanding of early severe-to-profound hearing loss on infants' attention to speech skills. In addition, the findings have significant clinical implications for early intervention on hearing loss, which emphasizes the importance of developing strong listening skills. A video abstract of this article can be viewed at: https://www.youtube.com/watch?v=f7xiYo3Ua08&feature=youtu.be.

How Auditory Experience Differentially Influences the Function of Left and Right Superior Temporal Cortices

To investigate how hearing status, sign language experience, and task demands influence functional responses in the human superior temporal cortices (STC) we collected fMRI data from deaf and hearing participants (male and female), who either acquired sign language early or late in life. Our stimuli in all tasks were pictures of objects. We varied the linguistic and visuospatial processing demands in three different tasks that involved decisions about (1) the sublexical (phonological) structure of the British Sign Language (BSL) signs for the objects, (2) the semantic category of the objects, and (3) the physical features of the objects.

Neuroimaging data revealed that in participants who were deaf from birth, STC showed increased activation during visual processing tasks. Importantly, this differed across hemispheres. Right STC was consistently activated regardless of the task whereas left STC was sensitive to task demands. Significant activation was detected in the left STC only for the BSL phonological task. This task, we argue, placed greater demands on visuospatial processing than the other two tasks. In hearing signers, enhanced activation was absent in both left and right STC during all three tasks. Lateralization analyses demonstrated that the effect of deafness was more task-dependent in the left than the right STC whereas it was more task-independent in the right than the left STC. These findings indicate how the absence of auditory input from birth leads to dissociable and altered functions of left and right STC in deaf participants.

SIGNIFICANCE STATEMENT Those born deaf can offer unique insights into neuroplasticity, in particular in regions of superior temporal cortex (STC) that primarily respond to auditory input in hearing people. Here we demonstrate that in those deaf from birth the left and the right STC have altered and dissociable functions. The right STC was activated regardless of demands on visual processing. In contrast, the left STC was sensitive to the demands of visuospatial processing. Furthermore, hearing signers, with the same sign language experience as the deaf participants, did not activate the STCs. Our data advance current understanding of neural plasticity by determining the differential effects that hearing status and task demands can have on left and right STC function.

Auditory Deprivation Does Not Impair Executive Function, But Language Deprivation Might: Evidence From a Parent-Report Measure in Deaf Native Signing Children

Deaf children are often described as having difficulty with executive function (EF), often manifesting in behavioral problems. Some researchers view these problems as a consequence of auditory deprivation; however, the behavioral problems observed in previous studies may not be due to deafness but to some other factor, such as lack of early language exposure. Here, we distinguish these accounts by using the BRIEF EF parent report questionnaire to test for behavioral problems in a group of Deaf children from Deaf families, who have a history of auditory but not language deprivation. For these children, the auditory deprivation hypothesis predicts behavioral impairments; the language deprivation hypothesis predicts no group differences in behavioral control. Results indicated that scores among the Deaf native signers (n = 42) were age-appropriate and similar to scores among the typically developing hearing sample (n = 45). These findings are most consistent with the language deprivation hypothesis, and provide a foundation for continued research on outcomes of children with early exposure to sign language.

Nonverbal Executive Function is Mediated by Language: A Study of Deaf and Hearing Children

Studies have suggested that language and executive function (EF) are strongly associated. Indeed, the two are difficult to separate, and it is particularly difficult to determine whether one skill is more dependent on the other. Deafness provides a unique opportunity to disentangle these skills because in this case, language difficulties have a sensory not cognitive basis. In this study, deaf (n = 108) and hearing (n = 125) children (age 8 years) were assessed on language and a wide range of nonverbal EF tasks. Deaf children performed significantly less well on EF tasks, even controlling for nonverbal intelligence and speed of processing. Language mediated EF skill, but the reverse pattern was not evident. Findings suggest that language is key to EF performance rather than vice versa.

Nonverbal auditory working memory: Can music indicate the capacity?

Different working memory (WM) mechanisms that underlie words, tones, and timbres have been proposed in previous studies. In this regard, the present study developed a WM test with nonverbal sounds and compared it to the conventional verbal WM test. A total of twenty-five, non-music major, right-handed college students were presented with four different types of sounds (words, syllables, pitches, timbres) that varied from two to eight digits in length. Both accuracy and oxygenated hemoglobin (oxyHb) were measured. The results showed significant effects of number of targets on accuracy and sound type on oxyHb. A further analysis showed prefrontal asymmetry with pitch being processed by the right hemisphere (RH) and timbre by the left hemisphere (LH). These findings suggest a potential for employing musical sounds (i.e., pitch and timbre) as a complementary stimuli for conventional nonverbal WM tests, which can additionally examine its asymmetrical roles in the prefrontal regions.