Abstract
Radical advancements in hearing technology in the last 30 years have offered some deaf and hard-of-hearing (DHH) children the adequate auditory access necessary to acquire spoken language with high-quality early intervention. However, meaningful achievement gaps in reading and spoken language persist despite the engineering marvel of modern hearing aids and cochlear implants. Moreover, there is enormous unexplained variability in spoken language and literacy outcomes. Aspects of signal processing in both hearing aids and cochlear implants are discussed as they relate to spoken language outcomes in preschool and school-age children. In suggesting areas for future research, a case is made for not only expanding the search for mechanisms of influence on outcomes outside of traditional device- and child-related factors, but also for framing the search within Biopsychosocial systems theories. This theoretical approach incorporates systems of risk factors across many levels, as well as the bidirectional and complex ways in which factors influence each other. The combination of sophisticated hearing technology and a fuller understanding of the complex environmental and biological factors that shape development will help maximize spoken language outcomes in DHH children and contribute to laying the groundwork for successful literacy and academic development.
Highlights
Assistive hearing technology for deaf and hard-of-hearing (DHH) children has seen great advancements in the last 50 years
One method that has been effective in assisting DHH children in accessing the phonology of their auditory language and applying it to reading is an instruction method based in visual phonics [118,119,120]. This intervention method is exciting in part because the results show that it is beginning to close the achievement gap in reading for some DHH children with hearing technology [110,111,112,113,114,115,116,117,118,119,120], and because of results like those of Kyle and Harris [131] that found that speechreading was the strongest single predictor of single-word reading ability, whereas vocabulary knowledge best predicted written sentence comprehension
Impressive advances in hearing technology have occurred in the last 30 years offering the opportunity for DHH children to have the adequate auditory access necessary to acquire spoken language with high-quality early intervention
Summary
Assistive hearing technology for deaf and hard-of-hearing (DHH) children has seen great advancements in the last 50 years. This review focuses on current-day hearing technology for children with permanent hearing loss, known as sensorineural hearing loss This type of hearing loss is due to damage to the cochlea but can include damage to the auditory nerve and, occasionally, structures in the central auditory system. Sensorineural hearing loss results in reduced audibility, and reduced spectral resolution (frequency or “pitch” is not heard as clearly as it is with typical hearing), poor temporal processing (difficulty following changes in sound that occur over time), Educ. Reduced dynamic range ( in the case of listeners with severe-to-profound hearing loss), and temporal and spectral resolution are some of the biggest challenges in successfully fitting listeners with hearing technology. The reason cochlear implants directly stimulate auditory nerve fibers is because they are intended to bypass irreparably damaged structures in the cochlea of listeners with severe-to-profound sensorineural hearing loss. Cochlear implants are intended for listeners who do not benefit from hearing aids
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