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Communication Development of Toddlers Who are Hard of Hearing

​​​Professionals working with young children know that it is important to identify delays in communication development as early as possible. This allows professionals to partner with parents to promote the child’s optimal development. However, professionals currently have a limited set of tools for assessing some of these early skills, including the speech production abilities of toddlers.

Researchers at Boys Town National Research Hospital are addressing this problem by creating new measurement tools and identifying promising assessment tools that have already been developed but are not widely used. Our researchers are collecting data on how useful these tools are for determining which children have communication delays, tracking children’s communication development over time, and predicting which children are going to continue having trouble with their communication skills.

In June, researchers from Boys Town National Research Hospital, in collaboration with their colleagues at the University of Iowa and the University of North Carolina - Chapel Hill, presented research on one of these tools at a national conference on child language disorders in Madison, Wisconsin. The research team, which is working together on a study called “Outcomes of Children with Hearing Loss,” administered the Open and Closed Set Test (developed by Dr. David Ertmer, Purdue University) to 39 children with normal hearing and 91 children with hearing loss. During administration of this tool, professionals and parents work together to prompt the child to imitate ten words and then find the picture that matches each word. Although two of the toddlers with normal hearing and 20 of the toddlers with hearing loss weren’t able to complete the task, most toddlers were – and the results told researchers a lot about the early communication development of these children.

According to Lauren Berry, M.S., CCC-SLP, a speech language pathologist and research team member at Boys Town National Research Hospital, the research team found that although some toddlers who are hard of hearing performed very well on the task, most had more trouble producing and understanding single words than did their peers with normal hearing.

“They especially had trouble producing sounds they couldn’t see others produce, such as the ‘d’ and ‘k’ sounds, which aren’t as easy to see as sounds like ‘b’ or ‘m’,” said Berry.

The research team also reported that toddlers who are hard of hearing had trouble producing the final sounds in words, like the “t” in “boat,” which may be a result of these sounds being more difficult to hear, especially in noisy situations or when children are far away from the person who is talking. The toddlers who struggled with producing these early sounds were also the toddlers who produced fewer words in their everyday talk. Additionally, boys had more trouble with this task than girls.

The researchers also found that the performance of the 2-year-olds on this measure could be used to predict how well the same children would perform on a common test of speech production when they were 3 years old.

“This finding is very encouraging, because it tells us that the measure is capturing important information about children’s early communication abilities,” said Sophie Ambrose, Ph.D., CCC-SLP​, a postdoctoral fellow and speech language pathologist at Boys Town National Research Hospital. “This tells us that we have identified a promising tool for identifying children who may be at risk for delays in communication development. When we find children who demonstrate delays on this measure, we should work with their parents to implement an intervention plan that promotes successful language outcomes for these children.”