Factors that influence the language and communication of hearing-impaired children
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 mild-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 diagnosis 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 studies - which evaluate and detail the potential long-term benefits of very early intervention for hearing-impaired children - need to be conducted.