Improving functional outcomes early in life will help improve
transition to adolescence and adulthood with less reliance on services and
supports. However, research to improve functioning has been focused on how
hearing loss affects auditory, speech, and language outcomes. It seems logical
to assume that improvement in these domains will translate to improvement in
functional performance; however our preliminary data suggest that the
functional outcomes in children who are deaf or hard-of-hearing are below what
is predicted. Unfortunately, there is a lack of studies researching factors
influencing functional performance and day-to-day activities of children who
are deaf or hard of hearing.
This project seeks to understand the specific nature of language
and nonverbal cognitive abilities in children who are deaf or hard-of-hearing.
Project participants will include individuals with and without cognitive
impairment. We will observe their day-to-day functional skills and
participation in daily life activities at home and at school.
The novel characterization of functional skill acquisition in this
population of children is the first step towards identifying critical periods
of development for targeted intervention strategies.
The current level of evidence (or lack thereof) regarding
functional skills in children with hearing loss is stifling progress towards
This study will fill a critical gap in evidence that impacts the
effectiveness of our management, interventions, and counseling of families.
Further, it will create the foundation by which effective evidence-based and
interventions targeting functional independence can be designed.
This project brings together perspectives from multiple
disciplines: special education, deaf education, developmental pediatrics,
audiology, otolaryngology, neuropsychology, speech-language pathology, and
Knowledge from this study may be used towards the earlier
identification (and earlier intervention) of children at high risk for poor
outcomes. Novel therapeutic approaches should consider how to maximize
successful language, communication, and functional skills that are appropriate
for a child’s cognitive abilities.
This study will enroll children (n=60) with bilateral permanent
hearing loss, with and without cognitive impairment. The evaluation of children
with normal hearing (n=30) with similar cognitive abilities provides a
comparison group allowing researchers to understand the effects of hearing loss
on functional skills.
are followed for 2 years and receive standardized neurocognitive, language, and
functional-adaptive skill assessments, including parent and teacher-report
measures at yearly intervals.