Early Hearing Detection and Vocabulary of Children With Hearing Loss.

The primary purpose of the current study was to examine the impact of the current EHDI 1-3-6 policy on vocabulary outcomes across a wide geographic area | Pediatrics

Background: To date, no studies have examined vocabulary outcomes of children meeting all 3 components of the Early Hearing Detection and Intervention (EHDI) guidelines (hearing screening by 1 month, diagnosis of hearing loss by 3 months, and intervention by 6 months of age). A secondary goal was to confirm the impact of other demographic variables previously reported to be related to language outcomes.

Results: The combination of 6 factors in a regression analysis accounted for 41% of the variance in vocabulary outcomes. Vocabulary quotients were significantly higher for children who met the EHDI guidelines, were younger, had no additional disabilities, had mild to moderate hearing loss, had parents who were deaf or hard of hearing, and had mothers with higher levels of education.

Conclusions: Vocabulary learning may be enhanced with system improvements that increase the number of children meeting the current early identification and intervention guidelines. In addition, intervention efforts need to focus on preventing widening delays with chronological age, assisting mothers with lower levels of education, and incorporating adults who are deaf/hard-of-hearing in the intervention process.

Yoshinaga-Itano, C. et al. (2017) Early Hearing Detection and Vocabulary of Children With Hearing Loss. Pediatrics. Vol. 140 (no. 2) e20162964


Speech Intelligibility and Psychosocial Functioning in Deaf Children and Teens with Cochlear Implants

Deaf children with cochlear implants (CIs) are at risk for psychosocial adjustment problems, possibly due to delayed speech–language skills | The Journal of Deaf Studies and Deaf Education


This study investigated associations between a core component of spoken-language ability—speech intelligibility—and the psychosocial development of prelingually deaf CI users. Audio-transcription measures of speech intelligibility and parent reports of psychosocial behaviors were obtained for two age groups (preschool, school-age/teen). CI users in both age groups scored more poorly than typically hearing peers on speech intelligibility and several psychosocial scales.

Among preschool CI users, five scales were correlated with speech intelligibility: functional communication, attention problems, atypicality, withdrawal, and adaptability. These scales and four additional scales were correlated with speech intelligibility among school-age/teen CI users: leadership, activities of daily living, anxiety, and depression.

Results suggest that speech intelligibility may be an important contributing factor underlying several domains of psychosocial functioning in children and teens with CIs, particularly involving socialization, communication, and emotional adjustment.

Full reference: Freeman, V. et al. (2017) Speech Intelligibility and Psychosocial Functioning in Deaf Children and Teens with Cochlear Implants. The Journal of Deaf Studies and Deaf Education. 22(3) pp.278-289.

Gesture Use in 14-Month-Old Toddlers With Hearing Loss and Their Mothers’ Responses

Ambrose, S.E. (2106) American Journal of Speech-Language Pathology. 25. pp. 519-531.


Purpose: This study examined the gesture use of 14-month-old toddlers with hearing loss (HL) and mothers’ responses to children’s early gesture use. Comparisons were made to symbolic language and to dyads in which the toddler had normal hearing (NH).


Conclusion: Although toddlers’ gesture abilities remain intact in the presence of HL, mothers were not maximally responsive to those gestures and thus should be coached to increase their provision of contingent feedback.

Read the full abstract here

Auditory-Verbal Therapy: Under the Lens of Empirical Evidence

Kaipa, R. (2016) Hearing Journal. 69(10) pp.  8-9


Auditory-verbal therapy (AVT) is notably one of the most popular approaches to improve communication skills of children with hearing impairment . Focusing on audition as the primary input for learning spoken language without relying on speech reading and gestures, AVT requires children with HI to wear amplification devices on a regular basis. The main differences between AVT and other oral-based rehabilitation approaches are that AVT is tailored to suit the individual needs of each client and that it requires the child’s parent or caregiver to be present at each session . From the time the first report on AVT was published in 1993 , AVT has been the choice of parents of children with HI for learning spoken language. Like any other treatment approach, it is imperative to evaluate empirical evidence to determine the efficacy of AVT.

A detailed review of studies on AVT outcomes conducted from 1993 to the present reveals a lack of strong evidence supporting the efficacy of this approach. Ten studies on AVT outcomes in speech and language development report that:

  • children with HI receiving AVT can successfully learn spoken language
  • socioeconomic status has no effect on AVT outcomes
  • hearing-impaired children over 3 years old can catch up with their hearing peers in terms of speech and language.

Read the full article here

Language and speech outcomes of children with hearing loss and additional disabilities

Cupples, L. et al. International Journal of Audiology. Published online: 14 September 2016

Objective: This study examined language and speech outcomes in young children with hearing loss and additional disabilities.

Design: Receptive and expressive language skills and speech output accuracy were evaluated using direct assessment and caregiver report. Results were analysed first for the entire participant cohort, and then to compare results for children with hearing aids (HAs) versus cochlear implants (CIs).

Study sample: A population-based cohort of 146 five-year-old children with hearing loss and additional disabilities took part.

Results: Across all participants, multiple regressions showed that better language outcomes were associated with milder hearing loss, use of oral communication, higher levels of cognitive ability and maternal education, and earlier device fitting. Speech output accuracy was associated with use of oral communication only. Average outcomes were similar for children with HAs versus CIs, but their associations with demographic variables differed. For HA users, results resembled those for the whole cohort. For CI users, only use of oral communication and higher cognitive ability levels were significantly associated with better language outcomes.

Conclusions: The results underscore the importance of early device fitting for children with additional disabilities. Strong conclusions cannot be drawn for CI users given the small number of participants with complete data.

Read the abstract here

Hearing impairment, cognition and speech understanding: exploratory factor analyses of a comprehensive test battery for a group of hearing aid users

Rönnberg , J. et al. International Journal of Audiology. Published online: 02 Sep 2016

Objective: The aims of the current n200 study were to assess the structural relations between three classes of test variables (i.e. HEARING, COGNITION and aided speech-in-noise OUTCOMES) and to describe the theoretical implications of these relations for the Ease of Language Understanding (ELU) model.

Study sample: Participants were 200 hard-of-hearing hearing-aid users, with a mean age of 60.8 years. Forty-three percent were females and the mean hearing threshold in the better ear was 37.4 dB HL.

Design: LEVEL1 factor analyses extracted one factor per test and/or cognitive function based on a priori conceptualizations. The more abstract LEVEL 2 factor analyses were performed separately for the three classes of test variables.

Results: The HEARING test variables resulted in two LEVEL 2 factors, which we labelled SENSITIVITY and TEMPORAL FINE STRUCTURE; the COGNITIVE variables in one COGNITION factor only, and OUTCOMES in two factors, NO CONTEXT and CONTEXT. COGNITION predicted the NO CONTEXT factor to a stronger extent than the CONTEXT outcome factor. TEMPORAL FINE STRUCTURE and SENSITIVITY were associated with COGNITION and all three contributed significantly and independently to especially the NO CONTEXT outcome scores (R2 = 0.40).

Conclusions: All LEVEL 2 factors are important theoretically as well as for clinical assessment.