Early Language and Literacy Acquisition in Children with Hearing Loss

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PROJECT SUMMARY/ABSTRACT The long-term objective of this programmatic line of research is to elucidate the relation of oral language, phonological processing, and print knowledge and literacy achievement for children with hearing loss who are developing spoken language. This translational work supports NIDCD's mission of reducing the burden of communication disorders such as hearing loss and will result in better methods of identifying preschool children with hearing loss who are most at-risk for later language and literacy deficits. Children with hearing loss have wide individual variation in literacy outcomes. The median reading outcome for 18-year-olds with hearing loss is at only a third grade level, but some researchers report reading levels within the average range. Thus, there is a critical need to develop methods of identifying which children with hearing loss in the preschool years are most at-risk for later deficits so high-impact intervention can be initiated as early as possible. For children with normal hearing, oral language, phonological processing, and print knowledge develop over the course of the preschool years and are moderate to strong predictors of later literacy achievement. Children with hearing loss exhibit difficulties in acquisition of each of these areas, with particular difficulty in phonological awareness, conceptual print knowledge, and complex syntax production. The contributions, however, of each preschool oral language, phonological processing, and print knowledge skill to later literacy achievement for children with hearing loss are unknown. The aims of this longitudinal study are to (a) determine the developmental trajectories of spoken and written language for children with hearing loss across the elementary school years, (b) determine the unique contributions of preschool oral language, phonological processing, and print knowledge to grade 3 literacy achievement in children with hearing loss, and (c) consider how lexical-semantic knowledge contributes to areas of particularly delayed growth in children with hearing loss, and how those delays specifically contribute to literacy outcomes in elementary school. This study will provide a better understanding about how spoken and written language develop, as well as how preschool oral language, phonological processing, and print knowledge contribute to later literacy achievement in children with hearing loss. Such knowledge will have a significant long-term impact on identification of preschool children with hearing loss who are most at-risk for later spoken language and literacy deficits, as well as the development of high-impact early intervention.