Document Detail


Longitudinal development of phonology and morphology in children with late-identified mild-moderate sensorineural hearing loss.
MedLine Citation:
PMID:  20548239     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Studies of language development in children with mild-moderate hearing loss are relatively rare. Longitudinal studies of children with late-identified hearing loss are relevant for determining how a period of unaided mild-moderate hearing loss impacts development. In recent years, newborn hearing screening programs have effectively reduced the ages of identification for most children with permanent hearing loss. However, some children continue to be identified late, and research is needed to guide management decisions. Furthermore, studies of this group may help to discern whether language normalizes after intervention and/or whether certain aspects of language might be vulnerable to persistent delays. The current study examines the impact of late identification and reduced audibility on speech and language outcomes via a longitudinal study of four children with mild-moderate sensorineural hearing loss.
DESIGN: Longitudinal outcomes of four children with late-identified mild-moderate sensorineural hearing loss were studied using standardized measures and language sampling procedures from at or near the point of identification (28 to 41 mos) through 84 mos of age. The children with hearing loss were compared with 10 age-matched children with normal hearing on a majority of the measures through 60 mos of age. Spontaneous language samples were collected from mother-child interaction sessions recorded at consistent intervals in a laboratory-based play setting. Transcripts were analyzed using computer-based procedures (Systematic Analysis of Language Transcripts) and the Index of Productive Syntax. Possible influences of audibility were explored by examining the onset and productive use of a set of verb tense markers and by monitoring the children's accuracy in the use of morphological endings. Phonological samples at baseline were transcribed and analyzed using Computerized Profiling.
RESULTS: At entry to the study, the four children with hearing loss demonstrated language delays with pronounced delays in phonological development. Three of the four children demonstrated rapid progress with development and interventions and performed within the average range on standardized speech and language measures compared with age-matched children by 60 mos of age. However, persistent differences from children with normal hearing were observed in the areas of morphosyntax, speech intelligibility in conversation, and production of fricatives. Children with mild-moderate hearing loss demonstrated later than typical emergence of certain verb tense markers, which may be related to reduced or inconsistent audibility.
CONCLUSIONS: The results of this study suggest that early communication delays will resolve for children with late-identified, mild-moderate hearing loss, given appropriate amplification and intervention services. A positive result is that three of four children demonstrated normalization of broad language behaviors by 60 mos of age, despite significant delays at baseline. However, these children are at risk for persistent delays in phonology at the conversational level and for accuracy in use of morphological markers. The ways in which reduced auditory experiences and audibility may contribute to these delays are explored along with implications for evaluation of outcomes.
Authors:
Mary Pat Moeller; Elizabeth McCleary; Coille Putman; Amy Tyler-Krings; Brenda Hoover; Patricia Stelmachowicz
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Ear and hearing     Volume:  31     ISSN:  1538-4667     ISO Abbreviation:  Ear Hear     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-02     Completed Date:  2011-01-04     Revised Date:  2012-05-07    
Medline Journal Info:
Nlm Unique ID:  8005585     Medline TA:  Ear Hear     Country:  United States    
Other Details:
Languages:  eng     Pagination:  625-35     Citation Subset:  IM    
Affiliation:
Boys Town National Research Hospital, Omaha, Nebraska 68131, USA. marypat.moeller@boystown.org
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MeSH Terms
Descriptor/Qualifier:
Articulation Disorders / diagnosis*,  etiology*
Child
Child, Preschool
Hearing Loss, Sensorineural / complications*,  diagnosis*
Humans
Infant
Language Development Disorders / diagnosis,  etiology
Longitudinal Studies
Phonetics
Semantics
Severity of Illness Index*
Speech Intelligibility
Grant Support
ID/Acronym/Agency:
P30DC04662/DC/NIDCD NIH HHS; R01 DC004300-13/DC/NIDCD NIH HHS; R01 DC006681-05/DC/NIDCD NIH HHS; R01DC006681/DC/NIDCD NIH HHS; R01DC04300/DC/NIDCD NIH HHS
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