Functional Communication of Children Who Are Deaf or Hard-of-Hearing

Objective: The primary aim of this study was to investigate the relationship between language levels and communication and social function skills in young children who are deaf/hard-of-hearing. Method: A cross-sectional design was used with participants sampled predominately from a single clinic setting. Children between 3 and 6 years of age with permanent bilateral hearing loss were enrolled in the study. All children received the Preschool Language Scales-Fifth Edition language assessment and a neurocognitive assessment using the Leiter International Performance Scale-Revised at the study visit. Communication and social function skills were measured using the Vineland Adaptive Behavior Scales-Second Edition (VABS-II; mean 100 +/- 15) and the Pediatric Evaluation of Disability Inventory (PEDI; mean 50 +/- 10). Results: Analysis included 65 children with mild to profound bilateral hearing loss (mean age 56.8 months, SD +/- 14.1); 52% had hearing loss in the mild to moderate range. The mean nonverbal intelligence quotient (IQ) was 95.7 (+/- 18.8), the mean receptive language standard score was 83.7 (+/- 18.6), and mean expressive language standard score was 83.0 (+/- 18.5). The mean VABS-II communication standard score was 89.1 (+/- 17.5), and the mean PEDI social function score was 39.6 (+/- 15.3). Both nonverbal IQ and receptive language relative to nonverbal IQ (the ratio of language to IQ) were significantly associated with communication and social functioning, explaining more than 50% of the variance in communication function scores. Children with language commensurate with their IQ had significantly higher communication and social function scores than children with language significantly lower than IQ. This finding was consistent across different levels of IQ and independent of degree of hearing loss. Conclusion: Even with early identification and intervention, hearing loss continues to have a life-long impact on functioning. It is important to identify when language levels are not meeting a child's capabilities in order to intervene most effectively.