Analysis of natural language input in preschool children with and without hearing loss: quantity, caregiver response types, and influence of demographic factors

Abstract

ABSTRACT This study investigated language input (adult word count, AWC; conversational turn count, CTC; response types; high-, mid-, and low-level) and language outcomes (receptive, expressive) in children aged 2–5 years with hearing loss (CwHL) and those with normal hearing (CwNH). Associations between language input and outcomes, relationships between language input, and demographics were examined. Language input was analyzed using full-day Language Environment Analysis (LENA) audio-recordings, and language outcomes were assessed using standardized language assessments in 14 CwHL and 20 CwNH. There were no significant differences in language input between CwHL (AWC/hr: M = 1137, SD = 554; CTC/hr: M = 48.26, SD = 19.18) and CwNH (AWC/hr: M = 1243, SD = 426; CTC/hr: M = 60.94, SD = 21.34). There were, however, significant differences between groups in response types and language outcomes. Caregivers of CwHL used less high- and more mid- and low-level responses than caregivers of CwNH (p = < .01). Language input in CwHL showed no association with language outcomes, and there were no correlations with demographic factors. For CwNH, receptive language was correlated with AWC/hr, CTC/hr, and high- and low-level response types (p = < .01); and expressive language was correlated with AWC/hr (p = < .01), CTC/hr (p = .02), and high- (p = .02) and low-level (p = < .01) response types significantly. Correlations were negative for low-level response types, with lower language scores associated with relatively more use of low-level responses. For CwNH, maternal education correlated with AWC/hr (p = < .01), and caregivers of younger CwNH had significantly more CTC/hr (p = < .01). Quantitative LENA data suggested comparable interaction frequency between groups. CwHL were exposed to more low-level response types, had significantly lower language scores. Further investigation into response types, child language outcomes, and therapeutic implications for CwHL is needed.