Audibility, Perception, and Cognition Laboratory, Boys Town National Research Hospital, Omaha, Nebraska, USA.
Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, USA.
Ear Hear. 2022 Mar/Apr;43(2):347-360. doi: 10.1097/AUD.0000000000001098.
Children who are hard of hearing (CHH) experience delays in spoken language and executive function, but the mechanisms for these deficits remain unresolved. Differences in auditory experience and language skills have been examined as contributing factors to deficits in executive function, primarily with children who are deaf and children with cochlear implants. The theoretical model of cumulative auditory experience quantifies auditory dosage as how much speech is audible and how often children wear their hearing aids. CHH with higher auditory dosage have better language outcomes than peers with less auditory dosage. However, the effects of auditory experience on executive function have not been studied in CHH. The goal of this study was to examine the influences of auditory experience and language skills on the development of executive function in CHH.
We collected measures of aided speech audibility, hearing aid use, executive function, and receptive vocabulary in 177 CHH and 86 children with typical hearing who were 5- to 10 years old and matched for socioeconomic status and nonverbal intelligence. Auditory dosage was calculated by combining each child's average hours of hearing aid use with their audibility for speech to create a variable that quantifies individual differences in auditory access.
CHH had lower receptive vocabulary and deficits in executive function related to working memory and selective attention compared to peers with typical hearing. CHH with greater auditory dosage had higher receptive vocabulary than CHH with lower auditory dosage. Better receptive vocabulary was associated with better scores on executive function measures related to working memory and attention. Auditory dosage was also directly associated with measures of verbal working memory.
CHH have deficits in language and some, but not all, areas of executive function related to working memory and attention. Auditory dosage was associated with language abilities and verbal working memory. Language was associated with individual differences in executive function skills related to attention and working memory. These results provide support for systems theories regarding the development of executive function in CHH. Interventions that improve auditory access and language may be effective for improving executive function related to working memory and attention in CHH.
患有听力障碍的儿童（CHH）在口语和执行功能方面存在延迟，但这些缺陷的机制仍未得到解决。听觉体验和语言技能的差异已被研究为导致执行功能缺陷的因素，主要涉及聋童和植入人工耳蜗的儿童。累积听觉体验理论模型将听觉剂量量化为可听到的语音量以及儿童佩戴助听器的频率。具有较高听觉剂量的 CHH 比听觉剂量较低的同龄人具有更好的语言结果。然而，听觉体验对 CHH 执行功能的影响尚未在 CHH 中进行研究。本研究的目的是研究听觉体验和语言技能对 CHH 执行功能发展的影响。
我们收集了 177 名 CHH 和 86 名听力正常儿童的助听语音可听度、助听器使用、执行功能和接受性词汇的测量值，这些儿童的年龄在 5 至 10 岁之间，社会经济地位和非语言智力相匹配。听觉剂量是通过将每个孩子的助听器使用平均小时数与其言语可听度相结合来计算的，该变量量化了个体在听觉通道上的差异。
CHH 的接受性词汇量较低，与正常听力的同龄人相比，在与工作记忆和选择性注意相关的执行功能方面存在缺陷。具有较高听觉剂量的 CHH 的接受性词汇量高于具有较低听觉剂量的 CHH。更好的接受性词汇量与工作记忆和注意力相关的执行功能测量得分更好相关。听觉剂量也与言语工作记忆的测量值直接相关。
CHH 在语言和一些但不是所有与工作记忆和注意力相关的执行功能领域存在缺陷。听觉剂量与语言能力和言语工作记忆有关。语言与注意力和工作记忆相关的执行功能技能的个体差异有关。这些结果为关于 CHH 执行功能发展的系统理论提供了支持。改善听觉通道和语言的干预措施可能对改善 CHH 与工作记忆和注意力相关的执行功能有效。
