Hearing In Young Children Research Articles

Outcomes of Aural Rehabilitation Provided in Person or by Telehealth Among Deaf/Hard of Hearing Young Children with Cochlear Implants or Hearing Aids.

Background: Cochlear implants and hearing aids may facilitate the development of listening and spoken language (LSL) in deaf/hard of hearing young children, but they require aural rehabilitation therapy-often unavailable outside urban areas-for optimal outcomes. This trial assessed the relative effectiveness of LSL therapy delivered either in person or by interactive video. The hypothesis was that telehealth service delivery would be noninferior to in-person therapy. Methods: Most parents refused randomization of their children to telehealth or in-person conditions; therefore, randomization was impossible. In consultation with the funder (NIDCD), the study design was modified. Parents were allowed to select their preferred study condition, and the study team was blinded to group membership. Forty-two families were in the in-person group and 35 in telehealth (40 and 30, respectively, after attrition). Primary endpoints were total score, auditory comprehension, and expressive communication on the Preschool Language Scale, 5th edition. There were several secondary speech, hearing, and language outcome measures. Assessments occurred at baseline and at follow-up after 6 months of LSL therapy. Results: Propensity scores were used to create two matched groups. At baseline, groups did not differ on PLS-5 scores. Change from baseline to F/U on age-equivalents for all three scores was nearly identical for both groups, although the telehealth group was younger, on average, than the in-person group. Discussion: Telehealth was noninferior to in-person services for all primary endpoints. For secondary outcomes, neither group demonstrated a significant advantage. Magnitudes of estimated group differences were small, suggesting nonsignificant differences not predominantly because of sample size. The telehealth group showed greater improvement on 15/24 of secondary language outcome measures. The findings provide evidence that telehealth is equivalent to in-person care for providing LSL therapy to young children with cochlear implants and hearing aids.

ISL-signing mothers' practices for boosting hearing-signing children's engagement in shared reading.

This longitudinal multiple-case study research focused on the scaffolding strategies that two Israeli deaf mothers use to boost their young hearing children's engagement in reading interactions. Despite being significant to language learning, few studies have examined the dialogic reading practices of deaf-signing mothers. The study shows that until the age of 22months, the mothers shared picture books with their children. Between the ages of 12 to 24months, the mothers used mostly low-demand cognitive prompts and responsive utterances. Between the ages of 24 to 36months, they used more high-demand prompts (including open-ended questions) and expanded their responses. In line with previous studies, this research demonstrated that the Israeli deaf mothers used the books as a foundation for storytelling and reading conversations. The shared reading provided the mothers with opportunities to model the construction of ISL narratives and language functional behaviors, such as asking questions, describing things or expanding on the text.

Lexical processing in children with hearing impairment in oral word reading in transparent Arabic orthography

AbstractWord recognition mechanisms constitute an essential contribution to reading achievement in both deaf and hearing children. Little is known about how children with hearing impairment (HI) manage to read aloud words in the vowelled Arabic transparent script which provides full vowel information. This study aimed to compare word and pseudoword reading accuracy and speed between 32 Lebanese children with HI and 32 younger hearing Lebanese children. The two groups were carefully matched for reading comprehension and oral comprehension levels. Length, word frequency, and lexicality effects were assessed to characterize the functioning of the lexical and sublexical reading procedures. Reading errors were also analyzed to document reading difficulties in transparent Arabic orthography in the sublexical route. The results show significant effects of length, word frequency, and lexicality on reading accuracy and speed in both groups. They also indicate underdeveloped sublexical and lexical routes in children with HI who read less accurately and faster than the younger hearing children. Reading errors are numerous in children with HI. The data are discussed in light of the Dual Route Cascaded model. Suggestions are made about how to improve reading processes in children with HI.

Hearing young children’s perspectives: Reflections on research into left-behind children’s lived experience in Chinese rural areas

Children’s right to be heard is an issue raised in recent years in the Global North, which has also been acknowledged by Chinese researchers currently studying child development and education. However, Chinese researchers still often prefer the perspectives of adults in their research on young children, citing a lack of suitable methodologogy for collecting and interpreting young children’s voices. This article recognises the significance of including young children’s perspectives in research. It discusses how Western methodologies for listening to their perspectives, such as the Mosaic approach, can be adapted for use in Chinese socio-cultural contexts. By reflecting on the first author’s research on the lived experience of leftbehind young children in a Chinese rural area, the article explores the development and implementation of such a methodology. The research findings indicate that the Mosaic approach, alongside phenomenological interviews and other research tools, provided an effective approach that enabled achievement of the research aims. Flexibility and reciprocity in relationships were two key contributors to effectiveness of this approach to research in a Chinese context.

Hearing young children’s musical voices

The first virtual International Society for Music Education (ISME) Early Childhood Music Education (ECME) seminar in July 2022, featured a provocative theme, Making Voices Visible in Early Childhood Music. Research papers, poster presentations and the keynote by Pauline Harris led us to consider ways to cast our attention on children’s voices through and about music. By listening deeply and visibly, we can expand our understanding of young children as musickers, leading to improved pedagogy, while providing a compass for further inquiry.

Baby Sign Language in the development of young hearing children: A review of selected studies

The aim of this theoretical article is to increase the cognitive value of the subject of Baby Sign Language, in particular their positive impact and significance for the development of a hearing child. Addressing this problem seems important because of constant interest in sign language for children, both among parents and scientists. Equally important is the argument of the lack of a sufficient number of Polish studies in this area. The article consists of a short introduction and four thematically and logically arranged parts. The first contains a synthetic description of the process of language acquisition and development as well as the communication of a young child. The second part presents the history of the Baby Sign Language, its basic assumptions and principles. The third part discusses the importance and benefits of using the Baby Sign Language in the development of a young child. The study ends with a short summary with final conclusions, which show, based on the presented empirical material, that the Baby Sign Language has a positive significance for the child's development in almost all its spheres, i.e. e.g. in the linguistic, cognitive, emotional and motor spheres.

Interrater Reliability for a Two-Interval, Observer-Based Procedure for Measuring Hearing in Young Children.

Purpose To overcome methodology limitations for studying auditory development in young children, we have recently developed an observer-based procedure that uses a conditioned, play-based, motor response (see Bonino & Leibold, 2017). The purpose of this article was to examine interrater reliability for the method. Method Video recordings of test sessions of 2- to 4-year-old children (n = 17) were examined. Detection of a 1000-Hz warble tone was measured with the Play Observer-Based, Two-Interval (PlayO2I) method in each of two conditions: for a fixed intensity level (30 dB SPL) or for a variable intensity level signal (0-30 dB SPL). All test sessions were scored independently by three observers (one real-time, two offline). Observer consensus was evaluated with Fleiss' kappa statistic. To determine if summary data were similar across the observers of each test session, the proportion of correct trials (fixed-level condition) or threshold (variable-level condition) were computed. Results The strength of observer consensus was classified as "almost perfect" and "substantial" for the fixed-level and variable-level conditions, respectively. Follow-up analysis of the variable-level data indicated that differences in observer consensus were seen based on the signal level, the type of response behavior provided by the child, and the confidence level of the real-time observer. Resulting summary data were similar across the three observers of each test session: no significant differences for estimates of the proportion of correct trials or threshold. Conclusions Results from this study confirm strong interrater reliability for the method. The PlayO2I method is a powerful tool for measuring detection and discrimination abilities in young children. Supplemental Material https://doi.org/10.23641/asha.12978197.

Ototoxicity monitoring in children treated with platinum chemotherapy

Objective: To review the prevalence, mechanisms, clinical presentation, risk factors and implications of platinum-induced ototoxicity in paediatric cancer patients based on published evidence, discuss options for monitoring hearing in young children during treatment and review long-term follow-up guidelines. Design: Narrative literature review. Results: Children treated with cisplatin are at high risk of hearing loss and early, accurate identification of ototoxicity is important for medical decision making and hearing rehabilitation. Challenges of monitoring hearing in young children during cancer treatment and options for monitoring hearing are discussed. Conclusion: Hearing loss has important consequences for the survivors of childhood cancer including communication, learning, cognition and quality of life. Due to the presentation and configuration of ototoxic hearing loss, the test frequencies that are prioritised and the sequence of testing may differ from standard paediatric hearing evaluations. Hearing should be monitored during treatment and after completion of therapy.

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses

Collecting reliable behavioral data from toddlers and preschoolers is challenging. As a result, there are significant gaps in our understanding of human auditory development for these age groups. This paper describes an observer-based procedure for measuring hearing sensitivity with a two-interval, two-alternative forced-choice paradigm. Young children are trained to perform a play-based, motor response (e.g., putting a block in a bucket) whenever they hear a target signal. An experimenter observes the child's behavior and makes a judgment about whether the signal was presented during the first or second observation interval; the experimenter is blinded to the true signal interval, so this judgment is based solely on the child's behavior. These procedures were used to test 2 to 4 year-olds (n = 33) with no known hearing problems. The signal was a 1,000 Hz warble tone presented in quiet, and the signal level was adjusted to estimate a threshold corresponding to 71%-correct detection. A valid threshold was obtained for 82% of children. These results indicate that the two-interval procedure is both feasible and reliable for use with toddlers and preschoolers. The two-interval, observer-based procedure described in this paper is a powerful tool for evaluating hearing in young children because it guards against response bias on the part of the experimenter.

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses.

Collecting reliable behavioral data from toddlers and preschoolers is challenging. As a result, there are significant gaps in our understanding of human auditory development for these age groups. This paper describes an observer-based procedure for measuring hearing sensitivity with a two-interval, two-alternative forced-choice paradigm. Young children are trained to perform a play-based, motor response (e.g., putting a block in a bucket) whenever they hear a target signal. An experimenter observes the child's behavior and makes a judgment about whether the signal was presented during the first or second observation interval; the experimenter is blinded to the true signal interval, so this judgment is based solely on the child's behavior. These procedures were used to test 2 to 4 year-olds (n = 33) with no known hearing problems. The signal was a 1,000 Hz warble tone presented in quiet, and the signal level was adjusted to estimate a threshold corresponding to 71%-correct detection. A valid threshold was obtained for 82% of children. These results indicate that the two-interval procedure is both feasible and reliable for use with toddlers and preschoolers. The two-interval, observer-based procedure described in this paper is a powerful tool for evaluating hearing in young children because it guards against response bias on the part of the experimenter.

Use of code-mixing by young hearing children of Deaf parents

In this study we followed the characteristics and use of code-mixing by eight KODAs – hearing children of Deaf parents – from the age of 12 to 36 months. The children's interaction was video-recorded twice a year during three different play sessions: with their Deaf parent, with the Deaf parent and a hearing adult, and with the hearing adult alone. Additionally, data were collected on the children's overall language development in both sign language and spoken language. Our results showed that the children preferred to produce code-blends – simultaneous production of semantically congruent signs and words – in a way that was in accordance with the morphosyntactic structure of both languages being acquired. A Deaf parent as the interlocutor increased the number of and affected the type of code-blended utterances. These findings suggest that code-mixing in young bimodal bilingual KODA children can be highly systematic and synchronised in nature and can indicate pragmatic development.

Confronting the language barrier: Theory of mind in deaf children

The current study addressed deaf children's Theory of Mind (ToM) development as measured by a battery of first- and second-order belief tasks. Both a chronological age-matched control group and a younger group of pre-school aged hearing children were compared to a group of deaf children born to hearing parents. A hearing native signer enacted each of the tasks, which were pre-recorded in video clips in English (SSE), British Sign Language (BSL) and spoken English, in order to consider all communication preferences of the deaf children. Results revealed no differences in performance between the deaf and the young hearing children. However, despite the inclusion of ToM tasks based on their preferred mode of communication, the deaf children performed significantly worse at the unexpected-content and second-order belief task compared with their age-matched controls. These findings imply a delay rather than a deficit in ToM in deaf children that could be attributed to limited opportunities to converse and overhear conversations about mental states.Learning outcomes: None.

An Alternative Approach to Early Literacy: The Effects of ASL in Educational Media on Literacy Skills Acquisition for Hearing Children

Early childhood educators need access to research-based practices and materials to help all children learn to read. Some theorists have suggested that individuals learn to read through “dual coding” (i.e., a verbal code and a nonverbal code) and may benefit from more than one route to literacy (e.g., dual coding theory). Although deaf children can successfully learn to read through American Sign Language (ASL) without sound, few have examined the contributions of sign language as a potential mode, within the verbal code, for hearing children. The purpose of the current investigation was to examine the effects of an educational video that utilizes ASL, in addition to other verbal and nonverbal content, on hearing preschoolers’ early ASL and literacy skills. Participants (N = 77) were randomly assigned to one of three groups: some viewed the video in ASL with sound; some viewed in ASL and without sound; and others did not view the video. Targeted ASL and early literacy skills were assessed before and after viewing. Statistical analyses determined whether scores changed from pretest to posttest, and results showed significant gains for children who viewed a combination of sound and ASL. Although gains were not found on the standardized measure of print and word awareness skills, the results suggest that young hearing children learned the content and skills that were explicitly taught in a video that utilized ASL, fingerspelling and print along with sound. Such results suggest that a visual language, ASL, may serve as an alternative route to literacy development.

The development of discourse referencing in Cantonese of deaf/hard-of-hearing children

This paper investigates the development of discourse referencing in spoken Cantonese of fifteen deaf/hard-of-hearing children studying in a sign bilingual and co-enrollment education programme in a mainstream setting in Hong Kong. A comparison of their elicited narratives with those of the hearing children and adults shows that, despite a delay in acquiring the grammatical markings for (in)definiteness in Cantonese, these d/hh children show sensitivity towards the referential properties of different types of nominal expressions and their corresponding mappings with discourse functions. Specifically, they produced more bare nouns across all discourse contexts but fewer existential constructions, pronouns, demonstratives, and classifier-related constructions. Their choice of nominal expressions and the observed errors show striking similarities to the productions by the younger hearing children in this study, suggesting that the d/hh children's route of development of discourse referencing is likely to be similar to that of hearing children despite a slower rate of development.

Learning to Look for Language: Development of Joint Attention in Young Deaf Children

Joint attention between hearing children and their caregivers is typically achieved when the adult provides spoken, auditory linguistic input that relates to the child's current visual focus of attention. Deaf children interacting through sign language must learn to continually switch visual attention between people and objects in order to achieve the classic joint attention characteristic of young hearing children. The current study investigated the mechanisms used by sign language dyads to achieve joint attention within a single modality. Four deaf children, ages 1;9 to 3;7, were observed during naturalistic interactions with their deaf mothers. The children engaged in frequent and meaningful gaze shifts, and were highly sensitive to a range of maternal cues. Children's control of gaze in this sample was largely developed by age two. The gaze patterns observed in deaf children were not observed in a control group of hearing children, indicating that modality-specific patterns of joint attention behaviors emerge when the language of parent-infant interaction occurs in the visual mode.

Developmental Effects and Spatial Hearing in Young Children With Normal-Hearing Sensitivity

Previous research suggests that young children have significant difficulty recognizing speech in the presence of background noise as compared with older children and adults. However, limited research exists that examines the developmental effects of speech recognition in noise in separate age groups of young children, especially in a classroom setting. The lack of research may relate to the limited number of tests with multiple, equally intelligible lists in noise that are also appropriate for young children. As a result, the goals of the present study include investigating (1) effects of age and (2) benefits of spatial separation of speech and noise sources on the speech recognition in noise performance of young children with normal-hearing sensitivity. A secondary goal of the study was to establish the validity and reliability of the Phrases in Noise Test (PINT) for assessing the 50% correct speech-in-noise threshold of young children. The investigators used a two-way repeated measures design to examine the main effects of age and spatial separation. Sixty-eight children in separate groups of 3-, 4-, 5-, and 6-year-olds and 17 adults completed two speech-recognition conditions with (1) speech and noise from the same loudspeaker at 0-degree azimuth (S0/N0) and (2) speech and noise from separate loudspeakers at 0- and 180-degree azimuth (S0/N180). Recruiting sites included local preschools and school districts for children and a university for adults. The results of this investigation suggest that younger children (<4 years of age) have significantly poorer speech-in-noise thresholds than older children and adults, and 4- and 5-year-old children also have significantly poorer performance than adults when speech and noise are presented from the same spatial location. All participants obtained significant spatial release from masking. On a parent and teacher screening questionnaire to assess educational risk, five of 12 children with at-risk behaviors had poor speech-in-noise thresholds relative to their peers. When two lists of the PINT are used, the test seems to be a valid and reliable measure for assessing young children's speech-in-noise thresholds. Young children exhibit significantly poorer speech recognition than do older children and adults in a classroom, especially when speech and noise are presented from the same location. Given the poor acoustics of typical classrooms, and the earlier age at which many children are educated, special modifications to classrooms may be necessary to improve listening through acoustic modifications or classroom amplification. A combination of a parent or teacher questionnaire and the PINT may be helpful in identifying children who are at risk for educational delays and listening difficulties in classrooms with typically poor acoustics.

Hearing Evaluation for Pediatric Cochlear Implant with ASSR

Objective: The aim of this study was to evaluate Auditory Steady-State Responses (ASSR) at high intensities in pediatric cochlear implant candidates and to compare the results to behavioral test responses. Method: This prospective study evaluated 54 children with severe-to-profound hearing loss, aged from 3 to 72 months, between January and December 2011. All had absent ABR and OAE responses. ASSR were evoked using binaural single frequency stimuli at 110 dBHL with a 10 dB-down seeking procedure. ASSR and behavioral test results were compared. Results: Forty-two subjects completed both ASSR and behavioral evaluation. In 13 children behavioral tests were not available, 1 had inconclusive ASSR. Among 42 children with absent ABR and OAE, 11 (26.1%) had bilateral ASSR, 10 correlated well to behavioral results. Four (9.5%) showed unilateral responses in at least 2 frequencies, all confirmed by behavioral results. Among 27 subjects with absent ASSR, 8 had no behavioral responses; 12 had responses only in low frequencies &gt;110 dBHL, 7 showed behavioral responses at all frequencies in medium to high intensities. No spurious ASSR responses were observed at 100 or 110 dBHL in any frequency. Conclusion: ASSR is a valuable tool to detect residual hearing in young children with absent ABR and OAE. No false-positive ASSR results were observed, but in 7 cases with absent ASSR, the test underestimated residual hearing as compared to the behavioral responses.

Age-related changes in talker recognition with reduced spectral cues

Temporal information provided by cochlear implants enables successful speech perception in quiet, but limited spectral information precludes comparable success in voice perception. Talker identification and speech decoding by young hearing children (5-7 yr), older hearing children (10-12 yr), and hearing adults were examined by means of vocoder simulations of cochlear implant processing. In Experiment 1, listeners heard vocoder simulations of sentences from a man, woman, and girl and were required to identify the talker from a closed set. Younger children identified talkers more poorly than older listeners, but all age groups showed similar benefit from increased spectral information. In Experiment 2, children and adults provided verbatim repetition of vocoded sentences from the same talkers. The youngest children had more difficulty than older listeners, but all age groups showed comparable benefit from increasing spectral resolution. At comparable levels of spectral degradation, performance on the open-set task of speech decoding was considerably more accurate than on the closed-set task of talker identification. Hearing children's ability to identify talkers and decode speech from spectrally degraded material sheds light on the difficulty of these domains for child implant users.

Le rôle des gestes dans la création et l’acquisition du langage

Imagine a child who has never seen or heard language. Would such a child be able to invent a language? Despite what one might guess, the answer is "yes". This chapter describes children who are congenitally deaf and cannot learn the spoken language that surrounds them. In addition, the children have not been exposed to sign language, either by their hearing parents or their oral schools. Nevertheless, the children use their hands to communicate--they gesture--and those gestures take on many of the forms and functions of language (Goldin-Meadow 2003a). The properties of language that we find in these gestures are just those properties that do not need to be handed down from generation to generation, but can be reinvented by a child de novo. They are the resilient properties of language, properties that all children, deaf or hearing, come to language-learning ready to develop. In contrast to these deaf children who are inventing language with their hands, hearing children are learning language from a linguistic model. But they too produce gestures, as do all hearing speakers (Feyereisen and de Lannoy 1991; Goldin-Meadow 2003b; Kendon 1980; McNeill 1992). Indeed, young hearing children often use gesture to communicate before they use words. Interestingly, changes in a child's gestures not only predate but also predict changes in the child's early language, suggesting that gesture may be playing a role in the language-learning process. This chapter begins with a description of the gestures the deaf child produces without speech. These gestures assume the full burden of communication and take on a language-like form--they are language. This phenomenon stands in contrast to the gestures hearing speakers produce with speech. These gestures share the burden of communication with speech and do not take on a language-like form--they are part of language.

Oral language and sign language: possible approaches for deaf people’s language development

Deafness is a sensory impairment which strongly affects the normal acquisition and development of linguistic abilities. Deaf people are severely hindered in the development of oral speech because they do not have direct access to the linguistic input and many of them do not acquire much more than the rudiments of oral communication. While hearing children acquire easily and naturally a spoken language, deaf children might acquire in the same way a sign language, exploiting the visual modality. This study investigated the general linguistic competence in Italian of four different groups of deaf individuals (orally-trained children with cochlear implants, native signers, non-native signers and deaf foreigners adolescents and adults), by using a standardized picture matching task, in order to determine the level of their linguistic competence. Results revealed that most deaf individuals showed a performance comparable to that of very young hearing children. Cochlear implanted children performed significantly better than all the other groups, and the less accurate performance was that of foreigner deaf students, who often have not any kind of underlying language. Despite the better performance of cochlear implanted children, who generally do not use the sign language, the best solution to approach the oral language would appear to be the combination of oral training and sign language, in order to be able to communicate with both the deaf and the hearing communities. The school system in this sense should find some strategies in order to help deaf foreigners to get access to the grammar of the oral language.