The missing link in language learning of children who are deaf or hard of hearing: Pragmatics

The Impact of Pragmatic Delays for Deaf and Hard of Hearing Students in Mainstream Classrooms

“…Many DHH students have age-appropriate language skills on formal measures of expressive language (ie, syntax and semantics), but they still experience significant delays and challenges in social functioning and overall classroom participation. 1,2 Yoshinaga-Itano 4 reported that despite other aspects of language being commensurate with their hearing peers, at 7 years of age, DHH students were unable to master pragmatic language skills using complex language. Tsach and Most 1 investigated mainstream classrooms and showed that DHH fourth-to sixth-grade students (aged 10-12 years) showed greater difficulties in following teacher instructions compared with their typically hearing peers.…”

“…13,14 Reported increases in education placement for DHH students into mainstream schools is strongly linked to changes in inclusive educational policies, earlier diagnosis through the introduction of neonatal hearing screening, earlier fitting of sophisticated technological listening devices such as cochlear implants and hearing aids, and earlier intervention. 4,[13][14][15][16] These advancements and increases in the number of DHH students attending mainstream schools have not yet translated into full social and academic inclusion for these students. 1,9,11 One possible explanation relates to delayed pragmatic skills in DHH students, which impact these students' academic, social and emotional skills, acceptance by typically hearing peers, and overall participation in classes with typically hearing peers.…”

“…Pediatric health care providers need to be aware that many school-aged DHH patients in their care may well be challenged by delayed pragmatic skills, including those who have ageappropriate language skills on formal language tests. Pragmatic language delays are not only observed in young DHH children, 4 but they extend into later childhood and adolescence. 7,17,24,25 A conversation with the child or adolescent and his or her family will help providers identify the presence of difficulties with the sophisticated social use of language, challenges navigating interactions in the classroom, or problems following detailed expository instructions.…”

Social skills in preschool children with unilateral and mild bilateral hearing loss

“…Even though the vocabulary skills of the HH children may have been sufficient, although delayed, there is a possibility that they still had considerable difficulties in other communication aspects, such as pragmatic language (Yoshinaga-Itano, 2015), which may have contributed to the psychosocial difficulties. As our study did not include data to investigate communication abilities other than vocabulary, no conclusions can be drawn on this issue.…”

“…This emphasis on pragmatic language, that is, the knowledge and perspectives acquired through conversations with others, has also received attention in DHH research. For example, Yoshinaga-Itano (2015) demonstrated that DHH children with vocabulary scores within the normal range still had considerable delays in pragmatic language development, including how to apologize, make promises or to request more information. It is also likely that such delays impact future transactions in which the child engages, thereby contributing to psychosocial difficulties.…”