Grammatical Outcomes of 3- and 6-Year-Old Children Who Are Hard of Hearing

Purpose: Spoken language skills of 3- and 6-year-old children who are hard of hearing (HH) were compared with those of children with normal hearing (NH). Method: Language skills were measured via mean length of utterance in words (MLUw) and percent correct use of finite verb morphology in obligatory contexts based on spontaneous conversational samples gathered from 185 children (145 HH, 40 NH). Aided speech intelligibility index (SII), better-ear pure-tone average (BE-PTA), maternal education, and age of amplification were used to predict outcomes within the HH group. Results: On average, the HH group had MLUws that were 0.25-0.5 words shorter than the NH group at both ages, and they produced fewer obligatory verb morphemes. After age, aided SII and age of amplification predicted MLUw. Aided SII and BE-PTA were not interchangeable in this analysis. Age followed by either BE-PTA or aided SII best predicted verb morphology use. Conclusions: Children who are HH lag behind their peers with NH in grammatical aspects of language. Although some children appear to catch up, more than half of the children who are HH fell below the 25th percentile. Continued monitoring of language outcomes is warranted considering that children who are HH are at increased risk for language learning difficulties.