Factors associated with reading comprehension in adolescents who are hard of hearing

许多重听儿童（CHH）在婴儿期就被发现并接受早期干预。然而，即使有这种早期干预，CHH也有由于听觉通路减少而延迟语言习得的风险。这些挑战可能会对阅读的发展产生连锁反应，因为语言在阅读中起着基础性的作用。许多关于听力损失儿童（HL）阅读理解的研究都集中在聋哑儿童或听力损失儿童与听力损失儿童的组合群体上。由于CHH有一个质量上不同的听觉信号比谁是聋人儿童，目前还不清楚，如果显着延迟，我们看到的字阅读和阅读理解聋人儿童适用于CHH在中学年级。这种证据的缺乏阻碍了我们对推动CHH阅读成就的潜在过程的理解，这反过来又限制了开发基于科学的干预和指导的能力。当前的建议是以简单的阅读观为指导的，该观点提出阅读理解是文字阅读和语言理解的产物。这个建议也是基于累积听觉经验模型，该模型预测，不一致的听觉访问在幼儿期导致减少语言学习的机会。具体来说，该提案测试的假设，听觉通路（量化的辅助可听度和助听器的使用量）预测阅读理解的增长率在CHH，这种关系是由口头语言介导的。目前的建议将纠正过去研究的一些局限性，利用我们获得的大量，特征良好的青少年听力困难（AHH）和年龄匹配的青少年听力正常（ANH），从学前班到四年级。我们建议对这一队列进行前瞻性测试，直到12年级。我们进入这个队列，将使我们能够进行严格的纵向调查的发展轨迹在单词水平的解码和文本水平的阅读理解，以及驱动这些轨迹的潜在过程。我们还将研究AHH阅读困难来源的异质性。提出了两个目标：目标1。建立CHH儿童阅读能力的发展轨迹，并描述AHH儿童阅读技能的发展特征。我们将通过回顾性（K-4年级）和前瞻性（7 - 12年级）数据的组合来评估这些轨迹和轮廓。目标二。详细说明影响AHH和ANH中阅读理解轨迹和结果的潜在过程。本提案中的数据将为HL儿童的阅读理论模型提供信息，使用强大的现代统计方法来检查阅读理解。这项研究将为识别支持幼儿和青少年阅读理解的独特组成技能提供经验证据。这一证据将指导差异化教学方法的发展和未来的干预研究，旨在验证这些基于科学的教学方法。

Many children who are hard of hearing (CHH) are identified and receive early intervention during infancy. Even with this early intervention, however, CHH are at risk for delays in language acquisition due to reduced auditory access. These challenges may have cascading effects on reading development because language plays a foundational role in reading. Much of the research on reading comprehension in children with hearing loss (HL) has focused on elementary-age children who are deaf or combined groups of CHH with children who are deaf. Because CHH have access to a qualitatively different auditory signal than children who are deaf, it is unclear if the significant delays we see with word reading and reading comprehension in children who are deaf apply to CHH in secondary grades. This lack of evidence hinders our understanding of the underlying processes that drive reading achievement in CHH, which in turn, limits the ability to develop scientifically based interventions and instruction. The current proposal is guided by the Simple View of Reading, which proposes that reading comprehension is the product of word reading and language comprehension. This proposal is also based on the Cumulative Auditory Experience model, which predicts that inconsistent auditory access in early childhood leads to reduced opportunities for language learning. Specifically, this proposal tests the hypothesis that auditory access (quantified by aided audibility and amount of hearing aid use) predicts reading comprehension growth rates in CHH, and this relationship is mediated by oral language. The current proposal will rectify some of the limitations of past research by leveraging our access to a large, well-characterized cohort of adolescents who are hard of hearing (AHH) and age-matched adolescents with normal hearing (ANH) who have been followed from preschool to 4th grade. We propose to prospectively test this cohort out to 12th grade. Our access to this cohort will allow us to conduct a rigorous longitudinal investigation of developmental trajectories in word-level decoding and text-level reading comprehension, as well as the underlying processes that drive these trajectories. We will also examine heterogeneity in sources of reading difficulty for AHH. Two aims are proposed: Aim 1. To establish developmental trajectories of reading in CHH and characterize the component reading skill profiles of AHH. We will evaluate these trajectories and profiles through a combination of retrospective (K-4th grade) and prospective (7th-12th grade) data. Aim 2. To specify the underlying processes that influence reading comprehension trajectories and outcomes in AHH and ANH. The data from this proposal will inform theoretical models of reading for children with HL, using robust and modern statistical approaches to examine reading comprehension. The proposed study will provide empirical evidence for the identification of unique component skills that support reading comprehension for young children and adolescents who are hard of hearing. This evidence will guide the development of differentiated instructional approaches and future intervention research designed to validate these scientifically based instructional approaches.