A diagnostic challenge: Language difficulties and hearing impairment in a secondary-school student from a non-English-speaking background (original) (raw)
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Frontiers in Education, 2016
Language impairment (LI) is one of the most common types of special educational needs (SENs), not only as a child's primary need but also as a secondary domain associated with other types of SENs. LI is a risk factor for children's later development , being associated with enhanced behavioral, emotional, and social difficulties, in particular peer problems and emotional difficulties; literacy difficulties, including both reading and writing; and reduced levels of academic achievement. Risks arising from LI in early childhood may also have an impact through adolescence and into adult life. This study uses national data from the UK government's annual census of all students aged 5–16 years attending state schools in England at four time periods between 2005 and 2011, over 6 million students at each census. We analyze the data on students with speech, language, and communication needs (SLCN), the Department for Education's category for students with LI, to examine the overall prevalence of SLCN and the variations in prevalence associated with child factors namely, age, gender, ethnicity, socioeconomic disadvantage, and having English as an additional language, and with contextual factors, namely the school and local authority. We also examine dispropor-tionality of identification of SLCN for different ethnic groups compared with White British children. We discuss the implications of our findings with respect to the current debates regarding the varied terminology for LI, including SLCN, and of a needs-based compared with diagnosis-based approach to assessing and making provision for children and young people with SENs. Keywords: language impairment, ethnicity, english as an additional language, special educational needs, overrepresentation analysis, speech language and communication needs, needs-based assessment, diagnostic assessment inTrODUcTiOn
Language Outcomes in Young Children with Mild to Severe Hearing Loss
Ear & Hearing, 2015
Objectives-This study examined the language outcomes of children with mild to severe hearing loss during the preschool years. The longitudinal design was leveraged to test whether language growth trajectories were associated with degree of hearing loss and whether aided hearing influenced language growth in a systematic manner. The study also explored the influence of the timing of hearing aid fitting and extent of use on children's language growth. Finally, the study tested the hypothesis that morphosyntax may be at particular risk due to the demands it places on the processing of fine details in the linguistic input. Design-The full cohort of children in this study was comprised of 290 children were hard of 34 hearing (CHH) and 112 children with normal hearing (CNH) who participated in the Outcomes 35 of Children with Hearing Loss (OCHL) study between the ages of 2 and 6 years. CHH had a mean better ear pure tone average of 47.66 dB HL (SD = 13.35). All children received a comprehensive battery of language measures at annual intervals, including standardized tests, parent report measures, and spontaneous and elicited language samples. Principal components analysis supported the use of a single composite language score for each of the age levels (2, 3, 4, 5, 6 years). Measures of unaided (better ear pure tone average, Speech Intelligibility Index) and aided (residualized Speech Intelligibility Index) hearing were collected, along with parent report measures of daily hearing aid use time. Mixed modeling procedures were applied to examine the rate of change (227 CHH; 94 CNH) in language ability over time in relation to 1) degree of hearing loss, 2) aided hearing, 3) age of hearing aid fit and duration of use, and 4) daily hearing aid use. Principal components analysis was also employed to examine factor loadings from spontaneous language samples and to test their correspondence with standardized measures. Multiple regression analysis was used to test for differential effects of hearing loss on morphosyntax and lexical development.
Journal of Developmental & Behavioral Pediatrics, 2017
Objective-(1) To examine language performance in the context of cognitive abilities in young children who are deaf or hard-of-hearing; and (2) to identify factors associated with having a language underperformance, defined as a gap between the language standard score and nonverbal IQ (NVIQ) standard score. Methods-Children 6-82 months of age with bilateral hearing loss were enrolled. Language performance was defined as a ratio of language skills relative to cognitive abilities with language underperformance defined as a ratio of language score to NVIQ<0.85. Results-Among 149 children, approximately half had hearing loss that was clinically classified as mild or moderate and over one-third received a cochlear implant. Participants had a mean NVIQ in the average range (95.4 (20.3)). Receptive language scores were significantly lower than their NVIQ by 10.6 points (p<.0001). Among children with NVIQs 80-100, 62.5% had receptive scores <85 and 50% had a language underperformance (ratio <0.85). Among children with NIVQs >100, 21.1% had receptive scores <85 with 42% having a language underperformance. Children with language underperformance (n=61, 41.5%) were more likely to have more severe levels of hearing loss, lower socioeconomic status, and be nonwhite. Conclusion-Many children early identified with hearing loss continue to demonstrate language underperformance, defined using their cognitive potential. Language deficits have a cascading effect on social functioning in children who are deaf or hard-of-hearing. This study highlights the need to understand a child's cognitive potential to adequately address language needs in existing intervention models.
Four-year follow-up study of language impaired children
Annals of Dyslexia, 1984
Children identified as normal or as specifically language impaired (SLI) were given speech, language, and intelligence testing on a longitudinal basis. Fourteen normal and 29 SLI children between the ages of 41/2 and 8 years were tested at Time 1. They were retested three to four years later when they were 8 to 12 years old. The results indicated that both the normal and the SLI children continued to develop skills in receptive and expressive language and speech articulation across the 3-to 4-year period intervening between evaluations. Overall, however, the SLI children appeared to develop language skills at a slower than normal rate Research supported by the March of Dimes, Grant #12-84.
Association between language and hearing disorders – risk identification
Clinics, 2017
OBJECTIVE: To identify children at risk for hearing and/or language disorders and to investigate the association between these risks by conducting pre-validated hearing and language screenings. METHODS: The study was conducted during a polio vaccination campaign in August of 2013 in basic health units in western Sã o Paulo. Parents of children between 2 and 5 years of age were asked to complete two screening tools: a hearing questionnaire (regarding hearing development) and a language production and comprehension scale (including the major language development milestones). The screening tools were administered by different researchers. We compared the risk of having language disorders among children at risk for hearing loss versus children not at risk, as well as the attributable risk and odds ratios. Chi-squared tests and logistic regression analyses were used. RESULTS: The study included 479 children with a mean age of three and one-half years, of whom 26.9% were identified as at risk for deficits in language production, 8.6% were at risk for deficits in language comprehension and 14% were at risk for hearing disorders. The children at risk for hearing disorders were twice as likely as those not at risk to exhibit language production and comprehension deficits. CONCLUSION: The results of this study highlight the importance of establishing and adopting low-cost procedures such as screenings to identify children at risk of developing language and/or hearing disorders in early childhood.
Language of Early- and Later-identified Children With Hearing Loss
PEDIATRICS, 1998
Objective. To compare the language abilities of earlier- and later-identified deaf and hard-of-hearing children. Method. We compared the receptive and expressive language abilities of 72 deaf or hard-of-hearing children whose hearing losses were identified by 6 months of age with 78 children whose hearing losses were identified after the age of 6 months. All of the children received early intervention services within an average of 2 months after identification. The participants' receptive and expressive language abilities were measured using the Minnesota Child Development Inventory. Results. Children whose hearing losses were identified by 6 months of age demonstrated significantly better language scores than children identified after 6 months of age. For children with normal cognitive abilities, this language advantage was found across all test ages, communication modes, degrees of hearing loss, and socioeconomic strata. It also was independent of gender, minority status, and ...
International Journal of Speech-language Pathology, 2010
This paper reports language ability and everyday functioning of 133 children with hearing impairment who were evaluated at 3 years of age, as part of the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. The language abilities of children were evaluated using the Preschool Language Scale (PLS-4), Peabody Picture Vocabulary Test (PPVT), Diagnostic Evaluation of Articulation and Phonology (DEAP) and Child Development Inventory (CDI). Everyday functioning of children was evaluated by interviewing parents using the Parents' Evaluation of Aural/oral performance of Children (PEACH) questionnaire. There were significant correlations among language measures, and also between the standardized language measures and the PEACH. On average, children who had language deficits exhibited difficulties in everyday functioning. The evidence lends support to a systematic use of parents' observations to evaluate communicative functioning of children in real life. On average, children's language attainment decreased as hearing loss increased, more so for children of less highly educated parents. Factors that were not significantly associated with speech and language outcomes at 3 years were age of amplification and socioeconomic status. As multiple factors affect children's outcomes, it will be possible to examine their effects on outcomes of children when all data in the LOCHI study are available.
Factors that influence the language and communication of hearing-impaired children
1996
Studies have shown that permanent childhood hearing impairment can have detrimental consequences for spoken-language development. It is widely accepted that early detection and intervention may improve outcomes for profoundly hearing-impaired children. However, few studies evaluate the influence on the families or give particular attention to children with rnild-to-severe hearing impairments. This research used spoken language and communication to focus on a range of factors that may influence outcomes for children with permanent sensorineural hearing impairments. In two studies, children with a range of hearing impairments, aged 32 to 85 months (mean = 63, s = 14) were audio-and video-recorded at home interacting with a major care-giver. Measures of spoken language for the children and their interlocutors were derived from transcripts. Controlling for the age of the child, spoken-language outcomes were evaluated in relation to factors such as the severity of the child's hearing impairment, age of intervention and the language addressed to the child during the interaction. The first study indicated that hearing severity, excluding profound hearing impairments, may not be the most important influence on spoken language. However, earlier intervention corresponded to better language performance. The second study failed to replicate these findings but suggested that a complex interaction of factors-including earlier referral for hearing assessment-may influence spoken language production for hearing-impaired children. Questionnaires revealed the families' attitudes and feelings towards the diagnosisl of their child's hearing-impairment, showing that parents often experienced negative emotions at the time and that intervention provisions often fail to take parental attitude into consideration at this time. Results also suggested that earlier and prompt intervention for childhood hearing-impairment is viewed as beneficial and essential. This may have important implications for habilitation and intervention programmes for hearing-impaired children and their families. The conclusions suggest that further 1 Throughout this thesis, 'diagnosis' refers to the time at which the child's hearing impainnent was initially confinned following fonnal audiological assessment studies-which evaluate and detail the potential long-term benefits of very early intervention for hearing-impaired children-need to be conducted. The children and families who took part in the studies; Mark Davies, who enabled me to complete this thesis by being so generous with his time, support and encouragement, along with Mark Shevlin and Stephanie Walker. Many thanks for the invaluable moral support given to me by Ingrid, Gail, Leda, Jed and my brother Eddie. Most especially, thank you Martin. This is dedicated to my parents who have made everything possible for me. "Without education, you are not going anywhere in this world" Malcolm X, May 29, 1964. Note on Appendix: The published article presented in the Appendix is work undertaken during my period of PhD study and is directly related to the contents of this thesis. Adrian Davis is included as a second author as he provided help and advice on the presentation of the results section and commented on earlier drafts of the paper. The main parts of the writing and data presentation are my own work, as are the contents of this thesis in its entirety. iii CONTENTS CONTENTS CHAPTER ONE 2.2.3 Spoken language development in hearing-impaired children: Delay versus deviance 2.2.4 Spoken language development in hearing-impaired children: Recent studies 2.2.5 Early intervention 2.3 COCHLEAR IMPLANTS AND CONDUCTIVE HEARING IMPAIRMENT 2.3.1 Cochlear implants and language development 2.3.2 Conductive hearing loss and language development 2.4 CHAPTER SUMMARY CHAPTER THREE COLLECTING AND ANALYSING CHILDREN'S LANGUAGE 74 3.1 A BRIEF REVIEW OF METHODS AND TOOLS FOR LANGUAGE ANALYSIS 3.1.1 Methodological issues in child language research 3.1.2 Language schedules 3.1.3 Analysis of spontaneous language samples 3.1.4 Mean length of utterance, vocabulary, and measures of interaction 3.2 LANGUAGE MEASURES 3.3 4.1 3.2.1 Language quantification 3.2.2 Selected language measures CHAPTER SUMMARY INTRODUCTION CHAPTER FOUR METHODS 4.2 PARTICIPANTS 4.2.1 General selection criteria 4.2.2 Contact procedure 4.3 DATA COLLECTION 4.3.1 Language samples and effects of observation 4.3.2 Equipment v 95 103 108 4.3.3 Procedure during visits 4.3.4 General background questionnaire 4.4 TRANSCRIPTION OF LANGUAGE SAMPLES 4.4.1 Transcription and coding conventions 111 4.4.2 Inter-transcriber reliabilities 118 4.5