15th ANNUAL EARLY HEARING DETECTION & INTERVENTION MEETING
March 13-15, 2016 • San Diego, CA

3/15/2016 | 1:45 PM - 2:15 PM | Topical Session 6 | Royal Palm 3/4 | 3 - Language Acquisition and Development

Impact of Language Underperformance on Communication and Social Functioning in Children Under 4 Years of Age Who Are Deaf or Hard of Hearing

Purpose: Social and communication skills are essential for developing independence. A discrepancy between language and cognitive ability, or language underperformance (LU) negatively impacts social functioning in older children who are deaf or hard of hearing (DHH). Little is known about younger children. We investigated the relationship between LU and functional skills in children <48 months who are DHH. Methods: Children with bilateral hearing loss, <3 years of age are being enrolled in a developmental study. Assessments include: the Mullen Scales of Early Learning or Leiter-R, Preschool Language Scales-5, the Pediatric Evaluation of Disability Inventory and Vineland Adaptive Behavior Scales. Language relative to cognitive abilities was defined as the ratio of receptive language score to nonverbal IQ (NVIQ). Children with language underperformance (ratio<80) were compared to children with commensurate language (ratio>80) regarding communication and social functioning scores using general linear models to control for confounding. Results: In 66 children, median age of identification 3 months, 30% have a cochlear implant, 32% have LU, 24% have NVIQ<80. Children with NVIQ>100 and LU had mean communication and social functioning standard scores significantly (p<0.01) lower than children with NVIQ>100 and commensurate language (78 vs 101 & 87 vs 103 respectively). Communication and social functioning was similar to children with NVIQ<80 with commensurate language (78 v 77, p=0.9 & 87 v 80, p=0.3 respectively). These relationships were not confounded by severity of hearing loss, child's age, age of identification. Conclusion: Language underperformance has a negative impact on social and communication skills in children who are DHH at very young ages and across all levels of ability. These deficits may have cascading effects on a range of developmental domains. Early recognition of slower language trajectories in young children who are DHH is critical and suggests a need for changes in current early intervention services.

Describe the relationship between language development and social functioning in children who are deaf or hard of hearing
Describe the importance of understanding language levels relative to cognitive abilities

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