Factors associated with nonword repetition skills in 4-to 6-year-old deaf and hard-of-hearing and typically hearing children.

Children identified as deaf and hard of hearing (DHH) exhibit an increased risk of speech and language difficulties. Nonword repetition (NWR) is a potential tool for identifying language difficulties in children with limited experience with the target language. In this study, we explored associations between auditory, linguistic, demographic and cognitive factors and NWR performance in DHH children and their typically hearing (TH) peers. We also examined the effect of the group on NWR outcomes when different factors were statistically controlled for. Our study included 68 4- to 6-year-old children: 18 with bilateral hearing aids (BiHAs), 18 with bilateral cochlear implants (BiCIs) and 32 with TH. The participants completed the Finnish Nonword Repetition Test comprising 24 test items with varying syllable lengths. The assessment methods also included tests of phonological, lexical, language comprehension and sentence repetition skills, along with a measure of nonverbal intelligence. The results showed that none of the auditory, linguistic, demographic and cognitive factors examined in the present study were correlated with NWR performance in the BiHA group, while significant correlations between NWR skills and linguistic abilities were observed in the BiCI group. The DHH children showed extraordinary difficulties in NWR compared to their TH peers, and these group differences remained after controlling for linguistic and demographic variables. The NWR task may be a potential clinical tool for identifying DHH children at risk for poor language outcomes and in need of speech and language intervention.

Spoken Language Skills in Children With Bilateral Hearing Aids or Bilateral Cochlear Implants at the Age of Three Years.

OBJECTIVES: Early hearing aid (HA) fitting and cochlear implants (CIs) aim to reduce the effects of hearing loss (HL) on spoken language development. The goals of this study were (1) to examine spoken language skills of children with bilateral HAs and children with bilateral CIs; (2) to compare their language skills to the age-norms of peers with normal hearing (NH); and (3) to investigate factors associated with spoken language outcomes. DESIGN: Spoken language results of 56 Finnish children with HL were obtained from a nationwide prospective multicenter study. Children with HL comprised two groups: children with mild-to-severe HL who used bilateral HAs (BiHA group, n = 28) and children with profound HL who used bilateral CIs (BiCI group, n = 28). Children's spoken language comprehension, expressive and receptive vocabulary, and phonological skills were compared with normative values of children with NH at the age of three years. Odds ratio (OR) was calculated to compare proportions of children below age-norms in BiHA and BiCI groups. Factors associated with spoken language outcomes were modeled with analysis of covariance. RESULTS: At the age of 3 years, 50%-96% of children with HL performed 1 SD or more below the mean of the normative sample of age-peers with NH in spoken language skills, depending on the language domain. Receptive vocabulary and phonological skills were the most vulnerable language domains. In receptive vocabulary, 82% of the children in the BiHA group and 50% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 4.4 times more likely to have poorer receptive vocabulary than the BiCI group. In phonological skills, 96% of children in the BiHA group and 60% of the children in the BiCI group scored 1 SD or more below the normative mean. The BiHA group was 18.0 times more likely to have poorer phonological skills than the BiCI group. The analysis of covariance models showed that unaided pure-tone average, PTA0.5-4 kHz, had a significant effect on spoken language comprehension in the BiHA group. For the BiCI group, age at HL diagnosis and age at CI activation had a significant effect on expressive vocabulary. High maternal level of education had a significant effect on language comprehension and expressive vocabulary and female gender on phonological skills. CONCLUSIONS: At the age of 3 years, especially receptive vocabulary and phonological skills caused difficulties for children with HL showing also considerable individual variation. Children with bilateral HAs seemed to be more likely to have poorer receptive vocabulary and phonological skills than children with bilateral CIs. A variety of factors was associated with outcomes in both groups. Close monitoring of spoken language skills of children with HL is important for ensuring similar opportunities for all children with HL and timely intervention, when needed.

Vocal Emotion Identification by Children Using Cochlear Implants, Relations to Voice Quality, and Musical Interests.

Purpose: Listening tests for emotion identification were conducted with 8-17-year-old children with hearing impairment (HI; N = 25) using cochlear implants, and their 12-year-old peers with normal hearing (N = 18). The study examined the impact of musical interests and acoustics of the stimuli on correct emotion identification. Method: The children completed a questionnaire with their background information and noting musical interests. They then listened to vocal stimuli produced by actors (N = 5) and consisting of nonsense sentences and prolonged vowels ([a:], [i:], and [u:]; N = 32) expressing excitement, anger, contentment, and fear. The children's task was to identify the emotions they heard in the sample by choosing from the provided options. Acoustics of the samples were studied using Praat software, and statistics were examined using SPSS 24 software. Results: The children with HI identified the emotions with 57% accuracy and the normal hearing children with 75% accuracy. Female listeners were more accurate than male listeners in both groups. Those who were implanted before age of 3 years identified emotions more accurately than others (p < .05). No connection between the child's audiogram and correct identification was observed. Musical interests and voice quality parameters were found to be related to correct identification. Conclusions: Implantation age, musical interests, and voice quality tended to have an impact on correct emotion identification. Thus, in developing the cochlear implants, it may be worth paying attention to the acoustic structures of vocal emotional expressions, especially the formant frequency of F3. Supporting the musical interests of children with HI may help their emotional development and improve their social lives.