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

许多重听儿童(CHH)在婴儿期就被识别并接受早期干预。然而，即使有了这种早期干预，CHH也面临着由于听觉通路减少而导致语言习得延迟的风险。这些挑战可能会对阅读发展产生连锁影响，因为语言在阅读中起着基础性的作用。大多数关于听力损失儿童(HL)阅读理解的研究都集中在小学聋儿或CHH和聋儿的混合组。由于CHH可以接触到与聋人儿童本质上不同的听觉信号，目前尚不清楚我们在聋人儿童的单词阅读和阅读理解方面看到的显著延迟是否适用于中学年级的CHH。缺乏证据阻碍了我们对推动CHH阅读成绩的潜在过程的理解，这反过来又限制了制定基于科学的干预和指导的能力。目前的建议是在简单阅读观的指导下提出的，该观点认为阅读理解是单词阅读和语言理解的产物。这一建议也是基于累积听觉体验模型，该模型预测，儿童早期不一致的听觉获取会导致学习语言的机会减少。具体地说，这一建议验证了这样一个假设，即听觉通路(通过辅助听力和助听器使用量来量化)预测了CHH的阅读理解成长率，并且这种关系是通过口语来调节的。目前的建议将纠正过去研究的一些局限性，方法是利用我们对大量具有良好特征的重听青少年(AHH)和年龄匹配的听力正常青少年(ANH)的队列进行跟踪，这些青少年从学龄前一直跟踪到四年级。我们建议对这个队列进行前瞻性测试，直到12年级。我们对这一群体的接触将使我们能够对词级解码和语篇水平阅读理解的发展轨迹以及驱动这些轨迹的潜在过程进行严格的纵向调查。我们还将检查AHH阅读困难来源的异质性。本研究提出了两个目标：目的1.建立高中生阅读发展轨迹，表征高中生阅读技能的成分特征。我们将通过回顾(K-4年级)和预期(7-12年级)数据的组合来评估这些轨迹和轮廓。目的2.明确影响AHH和ANH阅读理解轨迹和结果的潜在过程。这项提案的数据将为HL儿童阅读的理论模型提供参考，使用稳健和现代的统计方法来检查阅读理解。这项拟议的研究将为确定支持重听儿童和青少年阅读理解的独特成分技能提供经验证据。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.