Academic journal article American Annals of the Deaf

Rate of Language Growth in Children with Hearing Loss in an Auditory-Verbal Early Intervention Program

Academic journal article American Annals of the Deaf

Rate of Language Growth in Children with Hearing Loss in an Auditory-Verbal Early Intervention Program

Article excerpt

Historically, there have been widely recognized barriers and challenges to ensuring consistent progress and access to spoken language for children who are deaf (Gallaudet Research Institute, 2005; Marschark, 2006; Mitchell, 2004; Moeller et al., 2007). With the implementation of universal newborn hearing screening, studies examining outcomes of early identification and use of sensory devices at a young age report promising findings for the potential development of age-appropriate language skills (Meinzen-Derr, Wiley, & Choo, 2011; Yoshinaga-Itano, Sedey, Coulter, & Mehl, 1998). But despite technological advances coupled with early identification and intervention, not all children who are deaf are assured typical developmental growth trajectories for spoken language and auditory listening comprehension (Ertmer & Mellon, 2001; Warner-Czyz, Davis, & Morrison, 2005). Children with hearing loss may continue to vary greatly in their rate of language development, access to spoken language, and quality and quantity of exposure to language experience and instruction (Fagan & Pisoni, 2010; Geers, Moog, Biedenstein, Brenner, & Hayes, 2009; Moeller et al., 2007), making it difficult to predict their rate of language progress.

"Variability in language outcomes for children who are deaf is commonly reported in the literature. Svirsky, Robbins, Kirk, Pisoni, and Miyamoto (2000), for example, reported wide variability in communication outcomes of children with cochlear implants, with their skill levels ranging from age appropriate to severely delayed when tested 2 years after implantation. Research findings have implicated a multitude of factors that influence child and family outcomes, including age of identification (Yoshinaga-Itano & Apuzzo, 1998), sensory device use (Eisenberg, Kirk, Martinez, Ying, & Miyamoto, 2004; Geers, 2002), age at implantation (Frush & Svirsky, 2008; Geers et al., 2009; Hammes et al., 2002; Tomblin, Barker, Spencer, Zhang, & Gantz, 2005), length of implant use (Dornan, Hickson, Murdoch, & Houston, 2007, 2009; Dornan, Hickson, Murdoch, Houston, & Constantinescu, 2010; Geers, Brenner, & Davidson, 2003), cognitive skills (Geers, 2002; Geers, Brenner, & Davidson, 2003; Geers et al., 2009), communication method (Geers, Brenner, & Davidson, 2003; Geers, Spehar, & Sedey, 2002; Kirk, Miyamoto, Ying, Perdew, & Zuganelis, 2000), gender (Easterbrooks, O'Rourke, & Todd, 2000; Geers et al., 2009), and educational variables (Geers, 2002).

Given these numerous covarying influencing factors and the potential interactions between influencing conditions, children may vary greatly in their spoken-language and listening comprehension growth rate compared to chronological age-matched peers with normal hearing (Ertmer & Mellon, 2001; Warner-Czyz et al., 2005). The promise of age-appropriate speech and language skills following early hearing loss detection and intervention cannot be assured. Children who receive sensory devices at a young age may continue to experience difficulty decoding auditory signal or delays in acquiring adequate access to the incoming sound signal. These disturbances in access to spoken language potentially can affect perception and the production of semantic and syntactic aspects of language, creating delays in mastery of language forms. As a result, some aspects of receptive and expressive spoken-language development may appear "resistant" to early intervention for some children (Moeller et al., 2007) despite earlier identification and intervention.

Other studies (Dornan et al., 2007, 2009, 2010) have reported better rates of growth in language development, with substantial improvements in auditory comprehension, oral expression, total language, and articulation, particularly 2 years after implantation with intervention approaches that emphasize development of listening and spoken-language skills after cochlear implantation (e. …

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