BackgroundDeafness has an adverse impact on children's ability to acquire spoken languages. Signed languages offer a more accessible input for deaf children, but because the vast majority are born to hearing parents who do not sign, their early exposure to sign language is limited. Deaf children as a whole are therefore at high risk of language delays.AimsWe compared deaf and hearing children's performance on a semantic fluency task. Optimal performance on this task requires a systematic search of the mental lexicon, the retrieval of words within a subcategory and, when that subcategory is exhausted, switching to a new subcategory. We compared retrieval patterns between groups, and also compared the responses of deaf children who used British Sign Language (BSL) with those who used spoken English. We investigated how semantic fluency performance related to children's expressive vocabulary and executive function skills, and also retested semantic fluency in the majority of the children nearly 2 years later, in order to investigate how much progress they had made in that time.Methods & ProceduresParticipants were deaf children aged 6–11 years (N = 106, comprising 69 users of spoken English, 29 users of BSL and eight users of Sign Supported English—SSE) compared with hearing children (N = 120) of the same age who used spoken English. Semantic fluency was tested for the category ‘animals’. We coded for errors, clusters (e.g., ‘pets’, ‘farm animals’) and switches. Participants also completed the Expressive One‐Word Picture Vocabulary Test and a battery of six non‐verbal executive function tasks. In addition, we collected follow‐up semantic fluency data for 70 deaf and 74 hearing children, nearly 2 years after they were first tested.Outcomes & ResultsDeaf children, whether using spoken or signed language, produced fewer items in the semantic fluency task than hearing children, but they showed similar patterns of responses for items most commonly produced, clustering of items into subcategories and switching between subcategories. Both vocabulary and executive function scores predicted the number of correct items produced. Follow‐up data from deaf participants showed continuing delays relative to hearing children 2 years later.Conclusions & ImplicationsWe conclude that semantic fluency can be used experimentally to investigate lexical organization in deaf children, and that it potentially has clinical utility across the heterogeneous deaf population. We present normative data to aid clinicians who wish to use this task with deaf children.

Some deaf children continue to show difficulties in spoken language learning after cochlear implantation. Part of this variability has been attributed to poor implicit learning skills. However, the involvement of other processes (e.g. verbal rehearsal) has been underestimated in studies that show implicit learning deficits in the deaf population. In this study, we investigated the relationship between auditory deprivation and implicit learning of temporal regularities with a novel task specifically designed to limit the load on working memory, the amount of information processing, and the visual-motor integration skills required. Seventeen deaf children with cochlear implants and eighteen typically hearing children aged 5 to 11 years participated. Our results revealed comparable implicit learning skills between the two groups, suggesting that implicit learning might be resilient to a lack of early auditory stimulation. No significant correlation was found between implicit learning and language tasks. However, deaf children’s performance suggests some weaknesses in inhibitory control.

Recent improvements in cochlear implants (CIs) and hearing aid technology are providing deaf children better access to sounds, yet many children with CIs and digital hearing aids continue to experience significant difficulties in verbal language learning, reading, and writing. It has been shown that explicit and intentional memory processes, like verbal rehearsal or semantic organizational strategies, can explain the language and literacy outcomes of CI and hearing aid users. More recently, however, researchers have suggested also an involvement of implicit memory, and particularly implicit sequence learning (SL), in the language and literacy delay of these children. This chapter reviews and discusses studies bringing evidence of the involvement of inefficient explicit memory processes and implicit SL in the language and literacy development of children with CIs. It is argued that the interaction between explicit and implicit memory processes (verbal rehearsal and implicit SL) can better account for CI users’ problems with language and literacy acquisition.