Effectiveness of early storybook reading for promoting language and social communication skills with babies and young children with and without a hearing loss

Abstract

Reading storybooks with children, often referred to as early storybook reading (ESR), is considered among the most important activities parents can undertake to strengthen their children’s language and literacy development. The evidence in favour of ESR for supporting language development with toddlers, preschool, and primary school children is well documented. Given the positive improvements that have been reported from ESR with preschool and primary school children, further examination is warranted to investigate whether these benefits can be observed with even younger children as well as children who are at risk of language and social communication difficulties, such as babies with a hearing loss (HL). The research presented in this thesis examined the effectiveness of ESR with babies with and without a HL using a range of methodologies over four phases. Consistent with previous research with older children, it was hypothesised that ESR would be effective with babies with and without a HL for strengthening spoken language and social communication skills. In Phase 1, the home reading practices and values regarding ESR of parents with normal hearing (NH) babies and young children was examined using a questionnaire. Families (n = 113) from both a less advantaged socioeconomic area and more advantaged socioeconomic area participated. Analysis of the results revealed that parents appeared to value ESR and engaged in regular storybook reading with their children. Differences between the less advantaged area and more advantaged area were observed for frequency of ESR. Parents from both areas also indicated difficulties with selecting age appropriate books for babies and young children and creating a reading environment that promoted early language and social communication learning. The information from Phase 1 was used to develop an ESR intervention that was provided in the second phase of this thesis. In Phase 2, an ESR intervention was delivered to parents with NH babies (3-to 12-months-of-age) to examine the effectiveness of a high and low intensity ESR intervention to support parent-child interactions to strengthen language and social communication development. A pre-test, post-test comparison group design was conducted. The parents were allocated into two intervention conditions: a high intensity intervention group (n = 17) and a low intensity intervention group (n = 15). The findings suggested that ESR was effective for promoting language and broader social communication development for both groups. However, the high intensity group presented with significantly higher language and broader social communication scores with a large effect size immediately following the intervention, and the scores continued to be significantly higher than the low intensity group when the children were tested at 2-years-of-age. Following the findings from Phase 2, the high intensity ESR intervention was then trialled in Phase 3, with parents (n = 4) of babies (aged 9- to 15-months-of-age) with a HL, who are vulnerable to spoken language and social communication difficulties. All of the babies had a permanent HL and used hearing aids or cochlear implants. Using a multiple baseline single case experimental design across behaviours, the effectiveness of the ESR intervention for strengthening parents’ book selection skills, parent-child eye-contact/joint attention, and parent-child turn taking was investigated. Examination of the results revealed that ESR was effective for strengthening parent-child eye-contact/joint attention and parent-child turn taking for all four parent-baby dyads with a large effect size. However, ceiling effects for parents’ book selection skills were observed. The results provided preliminary evidence in favour of the ESR intervention with parents of babies with a HL and highlighted the need for future research to investigate the home reading practices and values regarding ESR of parents with babies and young children with a HL. Further examination of the home reading practices and values regarding ESR of parents with babies and young children with a HL was conducted in Phase 4 using a questionnaire. Following on from Phase 1, the same questionnaire that was provided to parents with NH babies and young children was trialled with parents (n = 12) with babies and young children with a HL (aged from less than 3-months-of-age to 3-yearsof- age). The findings suggested that parents with babies and young children with a HL valued ESR and read with their children frequently. Parents reported limited attendance at libraries and bookstores and demonstrated difficulties with book selection and using a seating position that created opportunities for eye-contact/joint attention and turn taking. Together, the four phases presented in this thesis advance our knowledge of ESR with babies and young children with and without a HL, facilitating a more holistic and comprehensive understanding of ESR. Consistent with our hypothesis, the studies presented in this thesis provide evidence for the effectiveness of ESR for strengthening spoken language and social communication skills for babies with and without a HL. The significance of these findings and clinical relevance is highlighted.