Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville.
Lang Speech Hear Serv Sch. 2021 Jan 19;52(1):335-353. doi: 10.1044/2020_LSHSS-20-00033. Epub 2020 Oct 28.
Purpose Better auditory prostheses and earlier interventions have led to remarkable improvements in spoken language abilities for children with hearing loss (HL), but these children often still struggle academically. This study tested a hypothesis for why this may be, proposing that the language of school becomes increasingly disconnected from everyday discourse, requiring greater reliance on bottom-up phonological structure, and children with HL have difficulty recovering that structure from the speech signal. Participants One hundred nineteen fourth graders participated: 48 with normal hearing (NH), 19 with moderate losses who used hearing aids (HAs), and 52 with severe-to-profound losses who used cochlear implants (CIs). Method Three analyses were conducted. Sentences with malapropisms were created, and children's abilities to recognize them were assessed. Factors contributing to those abilities were evaluated, including phonological awareness, phonological processing, vocabulary, verbal working memory, and oral narratives. Teachers' ratings of students' academic competence were obtained, and factors accounting for those ratings were evaluated, including the five listed above, along with word reading and reading comprehension. Results Children with HAs and CIs performed more poorly on malapropism recognition than children with NH, but similarly to each other. All children with HL demonstrated large phonological deficits, but they were especially large for children with CIs. Phonological awareness explained the most variance in malapropism recognition for children with CIs. Vocabulary knowledge explained malapropism recognition for children with NH or HAs, but other factors also contributed. Teachers rated academic competence for children with CIs more poorly than for children with NH or HAs, and variance in those ratings for children with CIs were primarily explained by malapropism scores. Conclusion Children with HL have difficulty recognizing acoustic-phonetic detail in the speech signal, and that constrains their abilities to follow conversations in academic settings, especially if HL is severe enough to require CIs. Supplemental Material https://doi.org/10.23641/asha.13133018.
目的 更好的听觉假体和更早的干预措施使听力损失（HL）儿童的口语能力得到了显著提高，但这些儿童在学业上仍常常感到吃力。本研究检验了一个假设，即为什么会这样，提出学校的语言变得越来越与日常话语脱节，需要更多地依赖自下而上的语音结构，而 HL 儿童很难从语音信号中恢复这种结构。 参与者 共有 119 名四年级学生参与了研究：48 名听力正常（NH），19 名使用助听器（HA）的中度听力损失者和 52 名使用人工耳蜗（CI）的重度至极重度听力损失者。 方法 进行了三项分析。 创作了用词不当的句子，并评估了儿童识别这些句子的能力。 评估了影响这些能力的因素，包括语音意识、语音处理、词汇、语词工作记忆和口头叙述能力。 还获得了教师对学生学业能力的评价，并评估了影响这些评价的因素，包括上述五个因素，以及单词阅读和阅读理解。 结果 与 NH 儿童相比，使用 HA 和 CI 的 HL 儿童在识别用词不当方面表现较差，但彼此之间相似。 所有 HL 儿童都表现出较大的语音缺陷，但 CI 儿童的语音缺陷尤其大。语音意识对 CI 儿童的用词不当识别解释了最多的差异。对于 NH 或 HA 儿童，词汇知识解释了用词不当的识别，但其他因素也有贡献。 教师对 CI 儿童的学业能力评价较差，而 CI 儿童的评价差异主要由用词不当得分解释。 结论 HL 儿童难以识别语音信号中的声学语音细节，这限制了他们在学术环境中参与对话的能力，尤其是如果 HL 严重到需要 CI 的程度。 补充材料 https://doi.org/10.23641/asha.13133018.
