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

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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.