Executive functioning and spoken language skills in young children with hearing aids and cochlear implants: Longitudinal findings

Vocabulary Composition Shapes Language Development in Children With Cochlear Implants

Although vocabulary size is thought to index children's language abilities, an increasing body of work suggests that regularities in children's vocabulary composition, particularly the proportion of shape-based nouns (e.g., cup), support language development. Here we examine initial vocabulary composition in children with hearing loss following cochlear implantation (n = 163) and age-matched children with normal hearing (n = 87). This comparison constitutes an experiment in nature for understanding how early vocabulary composition shapes subsequent language development in the context of the clinical provision of auditory experience. Children with higher initial proportions of shape-based nouns had larger vocabularies and scored higher on tests of receptive and expressive language abilities at 1, 2, and 3 years follow-up, than children whose vocabularies had lower proportions of shape-based nouns. These effects were strongest for cochlear implant users, especially 2-3 years postimplantation. The results suggest that knowing shape-based nouns facilitates language development and may ameliorate delayed language development trajectories.

Assessment of Linguistic Profile of Oral-Language-Proficient Hearing-Impaired Children Using Clinical Evaluation of Language Fundamentals: Fifth Edition (CELF5)

BACKGROUND/OBJECTIVES

Specific tests for the assessment of language development and language skills in deaf children are scarce. For this reason, parent inventories and/or standardized tests that are reliable and valid in the hearing population are used. The main aim of this study was to assess the usefulness of the Clinical Evaluation of Language Fundamentals 5 (CELF5) in determining the language skills of hearing-impaired children in a comprehensive way in comparison to their hearing peers.

METHODS

The sample consisted of 70 deaf and 73 hearing children aged 5-11 years. Although the results show statistically significant differences in language skills between deaf and hearing children, deaf children scored around average on 8 of the 12 subtests of the CELF5.

RESULTS

Children using total communication modality had the highest scores, followed by those using oral language and sign language. The CELF5 subtests showed high internal consistency in the deaf group. A percentile scale was also developed for this population group.

CONCLUSIONS

The CELF5 showed to be a reliable test for the assessment of receptive and expressive language in children with deafness who are competent in oral language. However, further research is needed to develop language assessment tests adapted to the deaf population that are sensitive to different communication modalities.

Association of domain-general speed of information processing with spoken language outcomes in prelingually-deaf children with cochlear implants

Spoken language development after pediatric cochlear implantation requires rapid and efficient processing of novel, degraded auditory signals and linguistic information. These demands for rapid adaptation tax the information processing speed ability of children who receive cochlear implants. This study investigated the association of speed of information processing ability with spoken language outcomes after cochlear implantation in prelingually deaf children aged 4-6 years. Two domain-general (visual, non-linguistic) speed of information processing measures were administered to 21 preschool-aged children with cochlear implants and 23 normal-hearing peers. Measures of speech recognition, language (vocabulary and comprehension), nonverbal intelligence, and executive functioning skills were also obtained from each participant. Speed of information processing was positively associated with speech recognition and language skills in preschool-aged children with cochlear implants but not in normal-hearing peers. This association remained significant after controlling for hearing group, age, nonverbal intelligence, and executive functioning skills. These findings are consistent with models suggesting that domain-general, fast-efficient information processing speed underlies adaptation to speech perception and language learning following implantation. Assessment and intervention strategies targeting speed of information processing may provide better understanding and development of speech-language skills after cochlear implantation.

Assessment of Executive Functions in Children with Sensorineural Hearing Loss and in Children with Specific Language Impairment: Preliminary Reports

Executive functions (EFs) are related abilities, associated with the frontal lobes functions, that allow individuals to modify behavioral patterns when they become unsatisfactory. The aim of this study was to assess EFs in children with sensorineural hearing loss (SNHL) and in children with "specific language impairment" (SLI), compared with a control group of children with normal development, to identify specific skill deficits. Three groups of preschool children aged between 2 and 6 years were assessed: 19 children with normal hearing, cognitive, and language development, 10 children with SNHL, and 20 children with SLI. The FE-PS 2-6 Battery was used for the assessment of preschool EFs, supplemented with the Modified Bell Test for the analysis of selective attention. Statistically significant differences were found between the two experimental groups and the control one, regarding the investigated skills. Children with SNHL showed a clear deficit in flexibility, whereas children with SLI had greater problems in self-regulation and management of waiting for gratification. Selective attention was found to be deficient in all three groups, with no statistically significant differences. This study shows that the skills investigated were found to be deficient in both SNHL and SLI patients. It is essential to start targeted exercises based on specific deficient skills as part of the rehabilitation program. It is of great importance to understand the consequences of EF deficit in preschool children to achieve an accurate diagnosis and carry out customized rehabilitation programs.

An Evaluation of Language Development and Working Memory in Children with Hearing Loss

BACKGROUND

 Children with hearing loss (HL) have difficulty in performing the complex functions of language, especially in noisy environments. Cognitive processes such as working memory and short-term memory are effective on individual differences in language skills in children with HL.

PURPOSE

 The present study aimed to evaluate the vocabulary and syntax skills in language development areas and working memory of children with HL and to compare these results with those of their peers with normal hearing (NH).

RESEARCH DESIGN

 In this study, a causal-comparative research model was used to measure vocabulary and syntax skills, which are among the working memory and language development skills of children with NH and those with HL.

STUDY SAMPLE

 A total of 88 children, 44 children with HL aged 60 to 107 (months) and age- and gender-matched 44 children with NH, were included in the study.

INTERVENTION

 Evaluation was made in two sessions of 20 minutes for each participant.

DATA COLLECTION AND ANALYSIS

 The language development and working memory of 44 children with HL and 44 children with NH were evaluated and the two groups were compared with each other. The Working Memory Scale (WMS) was used to evaluate the working memory of the participants and three subtests (vocabulary, sentence repetition, and sentence comprehension) of the Test of Language Development-Primary Fourth Edition: Turkish Version (TOLD-P:4) were used to evaluate language development. SPSS 23.0 program was used in the analysis of the data.

RESULTS

 Children with HL obtained lower scores than their peers with NH in all three TOLD-P subtests. Children with HL obtained significantly lower scores in WMS verbal memory and general WMS scores compared with NH children. A positive correlation was found between WMS Verbal Memory Scores and TOLD-P sentence comprehension and sentence repetition scores. WMS Visual Memory Scores predicted the group with HL and all TOLD-P scores and Verbal Memory Scores predicted the group with NH.

CONCLUSION

 Working memory skills are the predictor of language comprehension, reasoning, learning, literacy skills, and language development. Thus, including working memory skills as well as language skills in the education programs of children with HL contributes to the children's development.

Two are better than one: Differences in cortical EEG patterns during auditory and visual verbal working memory processing between Unilateral and Bilateral Cochlear Implanted children

Despite the proven effectiveness of cochlear implant (CI) in the hearing restoration of deaf or hard-of-hearing (DHH) children, to date, extreme variability in verbal working memory (VWM) abilities is observed in both unilateral and bilateral CI user children (CIs). Although clinical experience has long observed deficits in this fundamental executive function in CIs, the cause to date is still unknown. Here, we have set out to investigate differences in brain functioning regarding the impact of monaural and binaural listening in CIs compared with normal hearing (NH) peers during a three-level difficulty n-back task undertaken in two sensory modalities (auditory and visual). The objective of this pioneering study was to identify electroencephalographic (EEG) marker pattern differences in visual and auditory VWM performances in CIs compared to NH peers and possible differences between unilateral cochlear implant (UCI) and bilateral cochlear implant (BCI) users. The main results revealed differences in theta and gamma EEG bands. Compared with hearing controls and BCIs, UCIs showed hypoactivation of theta in the frontal area during the most complex condition of the auditory task and a correlation of the same activation with VWM performance. Hypoactivation in theta was also observed, again for UCIs, in the left hemisphere when compared to BCIs and in the gamma band in UCIs compared to both BCIs and NHs. For the latter two, a correlation was found between left hemispheric gamma oscillation and performance in the audio task. These findings, discussed in the light of recent research, suggest that unilateral CI is deficient in supporting auditory VWM in DHH. At the same time, bilateral CI would allow the DHH child to approach the VWM benchmark for NH children. The present study suggests the possible effectiveness of EEG in supporting, through a targeted approach, the diagnosis and rehabilitation of VWM in DHH children.