Language outcomes in children who are deaf and hard of hearing (Daub et al., 2017)

Purpose: Early auditory experiences are fundamental in infant language acquisition. Research consistently demonstrates the benefits of early intervention (i.e., hearing aids) to language outcomes in children who are deaf and hard of hearing. The nature of these benefits and their relation with prefitting development are, however, not well understood.Method: This study examined Ontario Infant Hearing Program birth cohorts to explore predictors of performance on the Preschool Language Scale–Fourth Edition at the time of (N = 47) and after (N = 19) initial hearing aid intervention.Results: Regression analyses revealed that, before the hearing aid fitting, severity of hearing loss negatively predicted 19% and 10% of the variance in auditory comprehension and expressive communication, respectively. After hearing aid fitting, children’s standard scores on language measures remained stable, but they made significant improvement in their progress values, which represent individual skills acquired on the test, rather than standing relative to same-age peers. Magnitude of change in progress values was predicted by a negative interaction of prefitting language ability and severity of hearing loss for the Auditory Comprehension scale.Conclusions: These findings highlight the importance of considering a child’s prefitting language ability in interpreting eventual language outcomes. Possible mechanisms of hearing aid benefit are discussed.Supplemental Material S1. Hearing Aid Speech Intelligibility Index (SII) values (N = 19) compared to Bagaetto et al., 2011, normative data. Supplemental Material S2. Graphs of each child's performance over time with 90% confidence intervals (CIs).Daub, O., Bagatto, M. P., Johnson, A. M., & Cardy, J. O. (2017). Language outcomes in children who are deaf and hard of hearing: The role of language ability before hearing aid intervention. Journal of Speech, Language, and Hearing Research, 60, 3310–3320. https://doi.org/10.1044/2017_JSLHR-L-16-0222

目的：婴幼儿早期的听觉经验对于语言习得至关重要。研究一致表明，早期干预（例如，使用助听器）对听障和重听儿童的语言成果具有显著益处。然而，这些益处的本质及其与预适配发展的关系尚不明确。方法：本研究检视了安大略省婴幼儿听力计划出生队列，以探讨在初始助听器干预时（N = 47）以及干预后（N = 19）对《学前语言量表第四版》表现的影响因素。结果：回归分析显示，在助听器适配前，听力损失的严重程度对听觉理解能力的方差贡献了19%，对表达沟通能力的方差贡献了10%。在助听器适配后，儿童在语言测量标准分上保持稳定，但其在进步值上的改善显著，进步值代表的是儿童在测试中获得的个体技能，而非与同龄人相对的位置。进步值的改变程度由预适配语言能力和听力损失严重程度的负交互作用预测，这一作用体现在听觉理解量表上。结论：这些发现突出了在解读最终语言成果时考虑儿童预适配语言能力的重要性。讨论了助听器益处的可能机制。补充材料S1：与Bagaetto等人（2011年）的正常数据相比，19名儿童的助听器语音可懂度指数（SII）值。补充材料S2：每位儿童随时间变化的性能图及其90%置信区间（CIs）。Daub, O., Bagatto, M. P., Johnson, A. M., & Cardy, J. O. (2017). 听障和重听儿童的语言成果：语言能力在助听器干预中的作用。言语、语言和听力研究杂志，60，3310–3320. https://doi.org/10.1044/2017_JSLHR-L-16-0222