This study has highlighted both the prevalence of hearing impairment in the very premature survivors and difficulties in compliance with a VROA based hearing screen. We see an advantage in directing resources towards an early screening test, such as TEOAE, that can be applied while the target population is still captive.

The ability to distinguish lies from sincere false statements requires understanding a speaker's communicative intentions and is argued to develop through linguistic interaction. We tested whether this ability was delayed in 26 children with severe-profound hearing loss who, based on vocabulary size, were thought to have relatively limited access to linguistic exchanges compared to typically-hearing peers (N = 93). Children were presented with toy bears who either lied or made a false statement. Despite identifying speakers' knowledge/ignorance, deaf or hard of hearing (DHH) children were delayed in identifying lies and mistakes when matched for chronological age. When matched for receptive vocabulary, observed discrepancies diminished. Deaf children who experience early access to conversations with their deaf parents demonstrated no delay. Findings suggest limited access to linguistic exchanges delays the development of a key pragmatic skill.

No abstract

BACKGROUND AND OBJECTIVES: A set of important pragmatic skills emerge during infancy and pave the way for later language learning. It is thought these early social communication skills develop through infant-caregiver interaction. In a microanalysis, we tested whether deaf and hard of hearing (DHH) infants (typically at high risk of reduced access to rich communicative interaction in infancy) are less likely to engage in gestural and vocal pragmatic behaviors. METHODS: We coded the naturalistic communication of 8 DHH infants who had no additional needs, who were not preterm or low birth weight, whose parents were hearing, monolingual English speakers, and who had spoken English as their primary target language. The frequency of use of 5 types of infant communication known to positively predict later language development (show gestures, give gestures, index-finger pointing, communicative vocalizations, and early word use) was compared with that of 8 typically hearing infants matched for age, sex, and socioeconomic status. RESULTS: Hearing loss had a significant negative effect on the frequency with which infants engaged in all types of early communication that predict later language development. CONCLUSIONS: DHH infants are at high risk of delay in the gestural and vocal communicative skills that lay the foundations for later language. Delay in the gestural domain suggests this is not simply a consequence of difficulties in imitating auditory stimuli. There is significant potential to lift DHH infants onto a positive developmental trajectory by supporting caregivers to nurture interaction from the first year.