Hearing Controls Research Articles

Spatial Cues Influence Time Estimations in Deaf Individuals.

SummaryRecent studies have reported a strong interaction between spatial and temporal representation when visual experience is missing: blind people use temporal representation of events to represent spatial metrics. Given the superiority of audition on time perception, we hypothesized that when audition is not available complex temporal representations could be impaired, and spatial representation of events could be used to build temporal metrics. To test this hypothesis, deaf and hearing subjects were tested with a visual temporal task where conflicting and not conflicting spatiotemporal information was delivered. As predicted, we observed a strong deficit of deaf participants when only temporal cues were useful and space was uninformative with respect to time. However, the deficit disappeared when coherent spatiotemporal cues were presented and increased for conflicting spatiotemporal stimuli. These results highlight that spatial cues influence time estimations in deaf participants, suggesting that deaf individuals use spatial information to infer temporal environmental coordinates.

Development and validation of the protocol for the evaluation of voice in patients with hearing impairment (PEV-SHI)

IntroductionThe voice of individuals with hearing impairment has been widely described, and can be compromised in all levels of the phonatory system. ObjectiveTo develop and validate an instrument for evaluating the voice of this population. MethodsThe instrument underwent the validation steps suggested by the Scientific Advisory Committee of the Medical Outcomes Trust. The study sample consisted of seventy-eight Brazilian people with cochlear implants (experimental group) and 78 individuals with normal hearing (control group), divided in groups by age range — children from 3 to 5 years; children from 6 to 10 years and adults from 18 to 46 years. The study sample participated in a voice recording of the sustained vowel /a/, connected speech and spontaneous conversation, in which three voice specialists rated using the proposed instrument. It consists of visual-analog scales of suprasegmental aspects, respiratory-phonatory coordination, resonance, phonation, additional parameters and general vocal perception. ResultsEvaluation by an expert committee and a pilot test established content validity. Reliability measures showed excellent test-retest reproducibility for the majority of the parameters. Analysis with the ROC curve showed that perceptual evaluation with the sustained vowel did not strongly differentiate individuals with cochlear implants from those with normal hearing, and the parameter “speech rate” did not differentiate the groups at all. For the connected speech and spontaneous conversation, the majority of the parameters differentiated the experimental group from the control group with an area under the curve ≥0.7. The cutoff values with maximum specificity and sensitivity were 30.5 for mild, 49.0 for moderate and 69.5 for intense deviation. ConclusionsThe protocol for the evaluation of voice in subjects with hearing impairment, PEV-SHI, is a reliable and useful tool for assessing the particularities of the voice of individuals with hearing impairment treated with cochlear implants and can be used in research and clinical settings to standardize evaluation and facilitate information exchange among services.

How Do You Deal With Uncertainty? Cochlear Implant Users Differ in the Dynamics of Lexical Processing of Noncanonical Inputs.

Work in normal-hearing (NH) adults suggests that spoken language processing involves coping with ambiguity. Even a clearly spoken word contains brief periods of ambiguity as it unfolds over time, and early portions will not be sufficient to uniquely identify the word. However, beyond this temporary ambiguity, NH listeners must also cope with the loss of information due to reduced forms, dialect, and other factors. A recent study suggests that NH listeners may adapt to increased ambiguity by changing the dynamics of how they commit to candidates at a lexical level. Cochlear implant (CI) users must also frequently deal with highly degraded input, in which there is less information available in the input to recover a target word. The authors asked here whether their frequent experience with this leads to lexical dynamics that are better suited for coping with uncertainty. Listeners heard words either correctly pronounced (dog) or mispronounced at onset (gog) or offset (dob). Listeners selected the corresponding picture from a screen containing pictures of the target and three unrelated items. While they did this, fixations to each object were tracked as a measure of the time course of identifying the target. The authors tested 44 postlingually deafened adult CI users in 2 groups (23 used standard electric only configurations, and 21 supplemented the CI with a hearing aid), along with 28 age-matched age-typical hearing (ATH) controls. All three groups recognized the target word accurately, though each showed a small decrement for mispronounced forms (larger in both types of CI users). Analysis of fixations showed a close time locking to the timing of the mispronunciation. Onset mispronunciations delayed initial fixations to the target, but fixations to the target showed partial recovery by the end of the trial. Offset mispronunciations showed no effect early, but suppressed looking later. This pattern was attested in all three groups, though both types of CI users were slower and did not commit fully to the target. When the authors quantified the degree of disruption (by the mispronounced forms), they found that both groups of CI users showed less disruption than ATH listeners during the first 900 msec of processing. Finally, an individual differences analysis showed that within the CI users, the dynamics of fixations predicted speech perception outcomes over and above accuracy in this task and that CI users with the more rapid fixation patterns of ATH listeners showed better outcomes. Postlingually deafened CI users process speech incrementally (as do ATH listeners), though they commit more slowly and less strongly to a single item than do ATH listeners. This may allow them to cope more flexible with mispronunciations.

Comparison of Otoacoustic Emissions in Asymptomatic Diabetes Mellitus and Normal Hearing Control Groups

Background: Diabetes mellitus (DM) is a chronic metabolic disorder. Previous studies reported the hearing impairment of diabetes patients as a progressive bilateral symmetrical sensorineural hearing loss (SNHL) of gradual onset which predominantly affected the higher frequencies, and found that diabetic patients had unsatisfactory hearing thresholds than nondiabetics in the same age group. For the use of evoked otoacoustic emissions (EOAEs) as a clinical test of hearing, EOAEs are sound which can be recorded in the outer ear canal and give objective information about preneural, mechanical elements of the cochlear function.
 Objective: To compare the otoacoustic emissions of asymptomatic DM patients with a normal hearing control group.
 Methods: All subjects received a routine audiologic evaluation which consisted of pure-tone air-bone conduction tests, tympanograms, and stapedius acoustic reflex tests. OAEs were measured in 30 asymptomatic diabetic patients with a mean age of 55.73 years and an age-matched 30 subjects normal hearing control group with a mean age of 50.87 years.
 Results: The pure-tone thresholds at 3, 4, 6, and 8 kHz; transient-evoked otoacoustic emissions (TEOAEs) amplitudes at 1, 1.5, 2, and 3 kHz; and the distortion product otoacoustic emissions (DPOAEs) amplitudes at 1, 1.5, 2, 3, 4, and 6 kHz were significantly different (P < .05) between the asymptomatic and control groups.
 Conclusions: This study suggested that diabetic patients had a significant hearing impairment. SNHL is gradually progressive and is a common condition in DM patients and their thresholds for hearing are higher at higher frequencies.

Can subtitles for the deaf and hard-of-hearing convey the emotions of film music? A reception study

ABSTRACTThe present paper describes a reception study into subtitling music in subtitles for the d/Deaf and hard-of-hearing. The study makes use of a database of film fragments that were selected and tested for eliciting a specific emotion. The research involves two highly emotional clips from the database as well as one control clip. The three excerpts were shown to a control group of 26 hearing people. Then, three versions of subtitles were added to each clip – one with music description, another with the composition title and the name of the performer, and another one with no information on the music. Subsequently, the fragments were shown to a test group of 60 d/Deaf and hard-of-hearing viewers divided into three groups. The participants reported on the emotions they felt by filling a Differential Emotions Scale questionnaire. For every emotion the clips were supposed to elicit, the results for each subtitling method are very similar to each other, suggesting that either method of subtitling music is equally effective in an emotional scene. Moreover, the emotion intensity the d/Deaf felt is also very close to the intensity experienced by the hard-of-hearing and the hearing control group.

Steady-state auditory evoked fields reflect long-term effects of repetitive transcranial magnetic stimulation in tinnitus

ObjectivesEvidence of plastic changes in tinnitus has been demonstrated in functional brain imaging. Although repetitive transcranial magnetic stimulation (rTMS) has been shown to decrease steady-state auditory evoked fields (SSAEFs) in tinnitus, the long-term consequence remained unknown. In addition, association between plastic changes as reflected by hemispheric asymmetry and tinnitus handicap inventory (THI) before and after rTMS have not been addressed. MethodsTwelve tinnitus patients received rTMS and 12 received sham stimulation. Another 12 healthy participants served as the normal hearing controls. Patients responded to the THI before the 1st session and at one month after the final session of rTMS/sham stimulation. Changes in brain activity were assessed by measuring SSAEFs. ResultsSSAEFs remained decreased one month after rTMS compared to before treatment, along with a significant reduction in THI score. There was no significant effect between the index of hemispheric asymmetry and THI score. ConclusionsThe current study objectively demonstrated the long-term effects of rTMS on tinnitus using SSAEFs. A longitudinal study to develop an index using SSAEFs to assess the subjective severity of tinnitus is warranted. SignificanceThis study suggests the possible use of SSAEFs to assess the long-term effects of rTMS on tinnitus.

Topological reorganization after partial auditory deprivation—a structural connectivity study in single-sided deafness

Growing evidence shows that partial auditory deprivation leads to extensive neural functional plasticity, which occurs not only in the auditory cortex but also in other sensory regions and cognitive areas. However, studies in structural topological properties are still limited, especially those investigating the relationship between structural connectome alterations and auditory abilities. To clarify this, we investigated white matter structural connectivity changes and the relationship between connection strength and hearing abilities in individuals with long-term single-sided deafness (SSD), a common form of partial hearing deprivation, using diffusion tensor imaging and network-based analysis. The results showed globally improved connection efficiency, locally weakened visual networks, and strengthened fronto-parietal sub-networks in SSD compared to normal hearing controls. Furthermore, a strong positive correlation between hearing abilities (including speech recognition in noise and sound localization) and connection strength, mainly in the fronto-parietal areas, was found in SSD. Our study reveals alteration of the structural network connections in SSD, especially in cognitive related networks, which showed close correlation with hearing abilities. Our findings provide new insights into topological white matter reorganization of the brain after partial sensory deprivation.

Downward cross-modal plasticity in single-sided deafness

The auditory cortex has been shown to participate in visual processing in individuals with complete auditory deprivation. However, it remains unclear whether partial hearing deprivation like single-sided deafness (SSD) leads to similar cross-modal plasticity. To investigate this, we enrolled individuals with long-term SSD, into functional MRI scans under resting-state and a visuo-spatial working memory task. Contrary to previous findings in bilateral deafness, our study revealed decreased activation in the auditory cortex in both left (LSSD) and right (RSSD) single-sided deafness compared to normal hearing controls, with statistical significance in RSSD. The degree of involvement was correlated with residual hearing ability in RSSD. These observations suggest that SSD can lead to a downward cross-modal plasticity: the more hearing ability lost, the fewer brain resources in the auditory cortex can be applied to visual tasks. In addition, the fronto-parietal cortex was observed to be less activated during the visual task in RSSD while the resting-state fMRI revealed increased functional connectivity between the fronto-parietal cortex and the auditory cortex, suggesting fronto-parietal resources may be recruited less by vision but more by hearing. The LSSD showed a similar alteration trend with RSSD, but without statistical significance. Together these findings may indicate that when hearing is partially deprived in SSD, there may be redistribution for brain resources between hearing and vision, and vision tends to allocate less resources. Our findings in this pilot study of unilateral auditory-deprived individuals enrich the understanding of cross-modal plasticity in the brain.

EEG rhythms lateralization patterns in children with unilateral hearing loss are different from the patterns of normal hearing controls during speech-in-noise listening

Unilateral hearing loss constitutes a field of growing interest in the scientific community. In fact, this kind of patients represent a unique and physiological way to investigate how neuroplasticity overcame unilateral deafferentation by implementing particular strategies that produce apparently next- to- normal hearing behavioural performances. This explains why such patients have been underinvestigated for a long time. Thanks to the availability of techniques able to study the cerebral activity underlying the mentioned behavioural outcomes, the aim of the present research was to elucidate whether different electroencephalographic (EEG) patterns occurred in unilateral hearing loss (UHL) children in comparison to normal hearing (NH) controls during speech-in-noise listening. Given the intrinsic lateralized nature of such patients, due to the unilateral side of hearing impairment, the experimental question was to assess whether this would reflect a different EEG pattern while performing a word in noise recognition task varying the direction of the noise source. Results showed a correlation between the period of deafness and the cortical activity asymmetry toward the hearing ear side in the frontal, parietal and occipital areas in all the experimental conditions. Concerning alpha and beta activity in the frontal and central areas highlighted that in the NH group, the lateralization was always left-sided during the Quiet condition, while it was right-sided in noise conditions; this evidence was not, however, detected also in the UHL group. In addition, focusing on the theta and alpha activity in the frontal areas (Broca area) during noise conditions, while the activity was always left-lateralized in the NH group, it was ipsilateral to the direction of the background noise in the UHL group, and of a weaker extent than in NH controls. Furthermore, in noise conditions, only the UHL group showed a higher theta activity in the temporal areas ipsilateral to the side where the background noise was directed to. Finally, in the case of bilateral noise (background noise and word signal both coming from the same two sources), the theta and alpha activity in the frontal areas (Broca area) was left-lateralized in the case of the NH group and lateralized towards the side of the better hearing ear in the case of the UHL group.Taken together, this evidence supports the establishment of a particular EEG pattern occurrence in UHL children taking place in the frontal (Broca area), temporal and parietal lobes, probably physiologically established in order to deal with different sound and noise source directions.

Prefrontal-Temporal Pathway Mediates the Cross-Modal and Cognitive Reorganization in Sensorineural Hearing Loss With or Without Tinnitus: A Multimodal MRI Study.

Objective: Hearing loss, one main risk factor of tinnitus and hyperacusis, is believed to involve significant central functional abnormalities. The recruitment of the auditory cortex in non-auditory sensory and higher-order cognitive processing has been demonstrated in the hearing-deprived brain. The dorsolateral prefrontal cortex (dlPFC), which has dense anatomical connections with the auditory pathway, is known to play a crucial role in multi-sensory integration, auditory regulation, and cognitive processing. This study aimed to verify the role of the dlPFC in the cross-modal reorganization and cognitive participation of the auditory cortex in long-term sensorineural hearing loss (SNHL) by combining functional and structural measurements.Methods: Thirty five patients with long-term bilateral SNHL and 35 matched healthy controls underwent structural imaging, resting-state functional magnetic resonance imaging (rs-fMRI), diffusion tensor imaging (DTI), and neuropsychological assessments. Ten SNHL patients were with subjective tinnitus.Results: No differences in gray matter volume, spontaneous neural activity, or diffusion characteristics in the dlPFC were found between the SNHL and control groups. The functional connectivity (FC) between the dlPFC and the auditory cortex and visual areas, such as the cuneus, fusiform, lingual cortex, and calcarine sulcus was increased in patients with SNHL. ANOVA and post hoc tests revealed similar FC alterations in the SNHL patients with and without tinnitus when compared with the normal hearing controls, and SNHL patients with and without tinnitus showed no difference in the dlPFC FC. The FC in the auditory cortex was associated with the symbol digit modality test (SDMT) scores in the SNHL patients, which reflect attentional function, processing speed, and visual working memory. Hearing-related FC with the dlPFC was found in the lingual cortex. A tract-based spatial statistics (TBSS) analysis revealed decreased fractional anisotropy (FA) values, mainly in the temporal inferior fronto-occipital fasciculus (IFOF), which showed remarkable negative correlations with the mean hearing thresholds in SNHL.Conclusion: Higher functional coupling between the dlPFC and auditory and visual areas, accompanied by decreased FA along the IFOF connecting the frontal cortex and the occipito-temporal area, might mediate cross-modal plasticity via top-down regulation and facilitate the involvement of the auditory cortex in higher-order cognitive processing following long-term SNHL.

Effect of Gamma Knife Radiosurgery on Vestibular Schwannoma with Serviceable Hearing: A Single-Center Indian Study

Gamma Knife radiosurgery (GKRS) is an established treatment modality for vestibular schwannomas (VSs). The tumor control and hearing preservation rates suggest that GKRS is a good alternative treatment for small- and medium-size VS. Data are lacking from India regarding GKRS for VSs. Our aim was to find the hearing preservation and tumor control rates and the factors contributing to these. In a retrospective 9-year study period, 87 patients had undergone GKRS for unilateral VS with Gardner-Robertson (GR) class I or II serviceable hearing. All 87 had been evaluated with magnetic resonance imaging and audiometry before GKRS and during follow-up to assess for the factors influencing tumor control and hearing preservation. Of the 87 patients, 77 with a minimum follow-up of 2 years and magnetic resonance imaging and audiometry evaluations available were included in the present study. The median follow-up period was 30 months. The tumor control rate and hearing preservation rate was 96.1% and 79.2%, respectively. Hearing preservation was not affected by the tumor volume. However, age >40 years, pre-GKRS pure tone average <30 decibels, speech discrimination score >85%, pre-GKRS Gardner-Robertson grade I hearing, mean cochlear dose <4 Gy, and pre-GKRS Ohata class of laterality C, D, E were significant on univariate analysis. The multivariate analysis revealed that age >40years (P= 0.017), pre-GKRS pure tone average <30decibels (P= 0.002), and Gardner-Robertson class I (P= 0.001) were significant factors. No patient developed cranial nerve dysfunction, hydrocephalus, or malignant degeneration. For most patients with small VSs, GKRS will be an effective alternative treatment to microsurgery with retained serviceable hearing and good tumor control.

Cued Speech Enhances Speech-in-Noise Perception.

Speech perception in noise remains challenging for Deaf/Hard of Hearing people (D/HH), even fitted with hearing aids or cochlear implants. The perception of sentences in noise by 20 implanted or aided D/HH subjects mastering Cued Speech (CS), a system of hand gestures complementing lip movements, was compared with the perception of 15 typically hearing (TH) controls in three conditions: audio only, audiovisual, and audiovisual + CS. Similar audiovisual scores were obtained for signal-to-noise ratios (SNRs) 11 dB higher in D/HH participants compared with TH ones. Adding CS information enabled D/HH participants to reach a mean score of 83% in the audiovisual + CS condition at a mean SNR of 0 dB, similar to the usual audio score for TH participants at this SNR. This confirms that the combination of lipreading and Cued Speech system remains extremely important for persons with hearing loss, particularly in adverse hearing conditions.

Facial emotion recognition in deaf children: Evidence from event-related potentials and event-related spectral perturbation analysis

Impairment of facial emotion recognition ability has been reported in deaf children, but few researches have examined the neural mechanism of this impairment. This study applied the electroencephalogram (EEG) technique to investigate the emotion recognition ability in 31 deaf children and 30 hearing controls with facial emotion recognition task. Results from behavioral task showed that deaf children exhibited lower accuracy compared to hearing controls. As for EEG analysis, results showed that deaf children showed diminished activation in the early (N1、P1), middle (N170) and late stages (late positive potential, LPP) compared to hearing controls. In addition, for brain oscillation, alpha band (400–800 ms) also revealed a reduced desynchronization in deaf children. The present findings seem to indicate that the deficit during facial emotion recognition ability among deaf children might be due to the impairments in visual processing, attention and emotional semantic distribution ability during facial emotion recognition processing.

Differences in Emotion Recognition From Body and Face Cues Between Deaf and Hearing Individuals.

Deaf individuals may compensate for the lack of the auditory input by showing enhanced capacities in certain visual tasks. Here we assessed whether this also applies to recognition of emotions expressed by bodily and facial cues. In Experiment1, we compared deaf participants and hearing controls in a task measuring recognition of the six basic emotions expressed by actors in a series of video-clips in which either the face, the body, or both the face and body were visible. In Experiment2, we measured the weight of body and face cues in conveying emotional information when intense genuine emotions are expressed, a situation in which face expressions alone may have ambiguous valence. We found that deaf individuals were better at identifying disgust and fear from body cues (Experiment1) and in integrating face and body cues in case of intense negative genuine emotions (Experiment2). Our findings support the capacity of deaf individuals to compensate for the lack of the auditory input enhancing perceptual and attentional capacities in the spared modalities, showing that this capacity extends to the affective domain.

Heavy metal blood levels and hearing loss in children of West Bengal, India.

Introduction:Heavy metals are a major environmental threat in India and there are several health risks associated with it. The aim of this study was to investigate the relationship between the blood levels of lead, cadmium, arsenic, and mercury and a sensoneurial hearing loss in children aged one to ten years.Method:Heavy metal blood levels were determined using inductively coupled plasma mass spectrometry, with appropriate quality control.Results:We found significantly higher blood lead concentration (mg/L; Mean ± SE) in children with a hearing loss (53.2 ± 4.4) compared to healthy controls (38.4 ± 4.7)/P = 0 0.03/.Conclusion:Children’s blood lead levels ≥ 50 mg/L compared to the levels < 10 mg/L were associated with increased probability of hearing loss (OR, 48.8; 95% CI, 41.9–55.6). The differences in the blood levels of cadmium, arsenic, and mercury between the children with a hearing loss and controls were statistically insignificant (P > 0.05).

An fMRI-study on single-sided deafness: Spectral-temporal properties and side of stimulation modulates hemispheric dominance.

ObjectiveOur main aim was to investigate the blood oxygenation level dependent (BOLD) response to monaural and binaural speech- and non-speech stimuli as measured with fMRI in subjects with single-sided deafness and in normal hearing controls. We hypothesised that the response to monaural stimulation in both normal hearing subjects and persons with single-sided deafness would vary with the complexity and nature of the stimuli and the side of stimulation.DesignPatients with left- and right single-sided deafness and controls with normal hearing receiving either binaural or monaural stimuli were tested using speech and non-speech auditory stimuli in an event-related fMRI experiment.Study sampleTwenty-two patients with single-sided deafness after treatment for vestibular schwannoma and 50 normal hearing controls.ResultsNormal hearing persons receiving right side monaural stimuli activate bilateral temporal regions. Activation following left side monaural stimulation is more right lateralized. Persons with single-sided deafness respond similarly to controls to monaural stimulation. Persons with right side single-sided deafness show activation of frontal cortical regions not seen in persons with left side single-sided deafness following speech stimuli. This is possibly related to increased effort and more frequently reported problems with communication. Right side single-sided deafness is related to increased activation of areas usually related to processing of degraded input, including the thalamus.ConclusionHemispheric dominance following monaural auditory stimulation is modulated by the spectral-temporal properties of the stimuli and by which ear is stimulated. Differences between patients with right- and left side deafness suggests that right side deafness is related to increased activation of areas involved in processing of degraded input.

Deaf and Hard of Hearing Students' Understanding of Causal and Adversative Connectives in Sentence Reading.

Deaf and hard of hearing (DHH) students tend to experience delayed development of grammatical skills in written language. However, much remains unknown about the mechanism behind this phenomenon. In the present study, the researchers used a self-paced moving-window reading task to investigate DHH students' understanding of causal and adversative connectives in Chinese. The students were similar to a hearing control group in their comprehension of the relationship between the clauses in a causal sentence. However, the DHH students were more likely than their hearing peers to find it harder to understand adversative connectives than causal connectives. More studies are needed to reveal how DHH students deal with other syntactic structures that are particularly difficult for them to learn. Educators should pay close attention to creating learning environments in which DHH students can acquire those syntactic structures in the process of using language.

Spelling in Children With Cochlear Implants: Evidence of Underlying Processing Differences.

This study compared the spelling skills and sub-skills of young children with cochlear implants (CIs) who use spoken language only (n = 14) with those of a same-aged typically hearing (TH) control group (n = 30). Spelling accuracy was assessed using irregular and nonsense word stimuli. Error and regression analyses were conducted to provide insight into the phonological and orthographic spelling strategies used by each group. Results indicated that children with CIs were as accurate as the TH group. However, misspellings made by the CI group were less phonologically plausible, and while nonword spelling accuracy was related to letter-sound knowledge for the TH group, the same relationship was non-significant for the CI group. Hence, despite demonstrating a similar degree of overall spelling success to TH children, children with CIs appeared to apply phonics skills less effectively.

Comparing physical activity and sedentary behavior levels between deaf and hearing adolescents

BackgroundDeaf adolescents may engage in less physical activity (PA) and longer sedentary time than their hearing peers. Yet, literature comparing PA levels and sedentary time between deaf and hearing control groups, as well as studies examining predictors of PA among deaf adolescents, are lacking. ObjectiveThis cross-sectional survey aimed to compare PA levels and sedentary time between the two groups and examine predictors (i.e., gender and social inclusion) of PA participation among deaf adolescents. MethodsParticipants were 98 deaf and 99 hearing adolescents, who completed the survey measuring the variables of interest. ResultsDeaf adolescents had a higher level of sedentary behavior as well as lower levels of light PA, moderate-to-vigorous PA, and total metabolic equivalent task (MET) than the hearing group. Only a small proportion of participants (deaf: 4%; hearing: 24%) met the World Health Organization's PA recommendation. Gender was found to negatively predict total MET among deaf, while social inclusion was a positive predictor. ConclusionsDeaf adolescents may have restricted PA participation. Measures should be used to promote social inclusion for increasing PA levels of this population.

The head the construct: Construct state nominals as a novel window to syntactic movement difficulties in hearing impairment

Children with hearing-impairment often show difficulties related to different kinds of syntactic movement. According to current syntactic analyses, Hebrew construct state nominals (CSN) involve syntactic movement, in which the noun moves to the determiner position. This kind of movement has never been tested in individuals with hearing-impairment. In this study we examined how Hebrew-speaking hearing-impaired children produce definite CSNs. A well-functioning movement of N to D prevents an overt determiner before the head of the definite CSN, and therefore we took the (incorrect) addition of a determiner before the head noun as an indication of a difficulty in moving the N to D.The participants were 32 children with hearing-impairment aged 9;1–12;2 whose performance was compared to 18 hearing children aged 8;10–10;7. We tested their oral reading of 63 CSNs in texts. The results showed that the children with hearing-impairment had a remarkable difficulty in reading the CSNs. The most noticeable error they made was that they incorrectly added a determiner before the head of the definite CSN, in addition to the determiner preceding the complement of the noun. The hearing control children virtually never made this error.Since the D position before the head should not be available if the noun had moved to D, we concluded that they could not properly move the noun to D. This illustrates, for the first time, a deficit in N-to-D movement in this population. The difficulty in N-to-D movement in the nominal domain is consistent with these children’s difficulties in other movement-derived structures in the clausal domain such as object A-bar movement and V-to-C movement. More broadly, these results support a movement analysis of CSN.