Comparing the vocabulary, grammatical, narrative, and phonological awareness skills among children with Hearing Loss and Normal Hearing and investigating the association between these language skills

Children with hearing loss (HL) are susceptible to language delay due to the reduced ability to receive and process audible sounds, and their access to normal language development is the main concern of their family and related professionals. This study aimed to investigate the differences present in macro- and micro-structures of oral narrative, lexical and phonological awareness skills among preschool-aged children with sensorineural HL who wear hearing aids (HA) or cochlear implant prosthesis (CI) and, children with typical development (TD). Also, the association between these language domains was explored.

Twenty-three HL children in the age range of 4 to 7 years old (including 13 children with HA and 10 children with CI), and 12 children with normal hearing were evaluated using storytelling, a lexical task, and three phonological awareness tasks. Narrative samples were transcribed and coded for several macro- (i.e., coherence) and micro-structure (i.e., grammatical complexity and cohesion) measures.

The language measures were not significantly different between children with HA and CI. Compared to their same-age peers, children with HA were significantly weaker in all language domains except syllable segmentation. Also, the scores of CI children were significantly lower than their TD peers in all language measures except syllable segmentation and coherence index (P<0.01). A positive and significant correlation (P<0.05) was observed among phonological awareness skills, lexical performances, and narrative macro- and micro-structure measures in both groups of children with HL and typical development.

Regardless of the type of hearing aids, children with HL are at greater risk for a deficit in basic and higher level language skills and so, need additional speech and language training, especially in preschool years. The associations between different language skills and their effects on language acquisition and rehabilitation of HL children are discussed.