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Rethinking Sound: Computer-assisted reading intervention with a phonics approach for deaf and hard of hearing children using cochlear implants or hearing aids
Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In the present thesis, computer-assisted reading intervention with a phonics approach was examined in deaf and hard of hearing children (DHH) aged 5, 6 or 7 years old using cochlear implants, hearing aids or a combination of both. Children with normal hearing (NH), matched for non-verbal intelligence and age, served as a reference group. Deaf and hard of hearing children constitute a heterogenetic population regarding cognitive and academic achievement. Many of them do not reach age appropriate levels in language and reading ability during their school years, with negative consequences for later training facilities and job opportunities. Finding relevant intervention methods to promote early language learning and literacy development that are easy to implement is therefore of great importance. In this thesis three aspects of cognitive ability (phonological processing skills, lexical access and working memory capacity), and reading ability was examined at three points in time; baseline 1, pre intervention and post intervention. Additionally, computer-assisted training delivered by  means of the Internet in the children’s homes was explored in order to determine whether it would be a useful and efficient method for the DHH population. Overall, the results from the present thesis support the notion that offering a computer-assisted intervention program delivered at home, is an alternative way to support not only NH children with reading difficulties but also to support DHH children’s phonological development and decoding proficiency.

Abstract [sv]

I denna avhandling undersöktes fonologisk lästräning vid datorn för döva och hörselskadade barn 5, 6 och 7 år gamla som använde cochleaimplantat, hörapparat eller en kombination av båda. Barn med normal hörsel som var matchade avseende icke-verbal intelligens och ålder utgjorde jämförelsegrupp. Döva och hörselskadade barn utgör en heterogen grupp avseende kognitiv förmåga och skolframgång. Många av dem når inte kraven för åldern avseende språk och läsförmåga under skoltiden vilket får negativa konsekvenser för senare utbildning och arbete. Att hitta relevanta interventionsmetoder för att främja tidig språkinlärning och läsutveckling som är lätta att genomföra, är därför av stor betydelse. I avhandlingen undersöktes tre aspekter av kognitiv förmåga (fonologisk bearbetningsförmåga, lexikal åtkomst och arbetsminneskapacitet) och läsförmåga vid tre tidpunkter; förtest 1, före intervention och efter intervention. Dessutom undersöktes om datorbaserad intervention som genomförs via Internet i hemmet, skulle vara en användbar och effektiv metod för döva och hörselskadade barn. Resultaten i stort visar att fonologisk lästräning vid datorn i barnens hem är en alternativ metod att stödja inte bara barn i risk att utveckla lässvårigheter, utan även döva och hörselskadade barns fonologi och avkodningsförmåga.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2014. , 108 p.
Series
Linköping Studies in Arts and Science, ISSN 0282-9800 ; 627Studies from the Swedish Institute for Disability Research, ISSN 1650-1128 ; 63
Keyword [en]
Computer-assisted reading intervention, phonics approach, deaf and hard of hearing, children, cochlear implants, hearing aids
Keyword [sv]
Datorbaserad fonologisk lästräning, döva och hörselskadade barn, cochleaimplantat, hörapparat
National Category
Other Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-108902DOI: 10.3384/diss.diva-108902ISBN: 978-91-7519-270-3 (print)OAI: oai:DiVA.org:liu-108902DiVA: diva2:733817
Public defence
2014-09-05, I:101, Hus I, Campus Valla, Linköpings universitet, Linköping, 10:00 (Swedish)
Supervisors
Available from: 2014-07-11 Created: 2014-07-11 Last updated: 2014-09-09Bibliographically approved
List of papers
1. Computer-assisted training of phoneme–grapheme correspondence for children who are deaf and hard of hearing: Effects on phonological processing skills
Open this publication in new window or tab >>Computer-assisted training of phoneme–grapheme correspondence for children who are deaf and hard of hearing: Effects on phonological processing skills
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2013 (English)In: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 77, no 12, 2049-2057 p.Article in journal (Refereed) Published
Abstract [en]

Objective

Examine deaf and hard of hearing (DHH) children's phonological processing skills in relation to a reference group of children with normal hearing (NH) at two baselines pre intervention. Study the effects of computer-assisted phoneme–grapheme correspondence training in the children. Specifically analyze possible effects on DHH children's phonological processing skills.

Methods

The study included 48 children who participated in a computer-assisted intervention study, which focuses on phoneme–grapheme correspondence. Children were 5, 6, and 7 years of age. There were 32 DHH children using cochlear implants (CI) or hearing aids (HA), or both in combination, and 16 children with NH. The study had a quasi-experimental design with three test occasions separated in time by four weeks; baseline 1 and 2 pre intervention, and 3 post intervention. Children performed tasks measuring lexical access, phonological processing, and letter knowledge. All children were asked to practice ten minutes per day at home supported by their parents.

Results

NH children outperformed DHH children on the majority of tasks. All children improved their accuracy in phoneme–grapheme correspondence and output phonology as a function of the computer-assisted intervention. For the whole group of children, and specifically for children with CI, a lower initial phonological composite score was associated with a larger phonological change between baseline 2 and post intervention. Finally, 18 DHH children, whereof 11 children with CI, showed specific intervention effects on their phonological processing skills, and strong effect sizes for their improved accuracy of phoneme–grapheme correspondence.

Conclusion

For some DHH children phonological processing skills are boosted relatively more by phoneme–grapheme correspondence training. This reflects the reciprocal relationship between phonological change and exposure to and manipulations of letters.

Place, publisher, year, edition, pages
Elsevier, 2013
Keyword
Deaf and hard of hearing; Children; Cochlear implants; Hearing aids; Phonological processing skills; Computer-assisted intervention
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-100465 (URN)10.1016/j.ijporl.2013.10.007 (DOI)000328870800027 ()
Projects
Neurofysiologiska aspekter på hörande
Available from: 2013-11-08 Created: 2013-11-08 Last updated: 2017-12-06
2. Predictors of phonological change in deaf and hard of hearing children who use cochlear implants or hearing aids
Open this publication in new window or tab >>Predictors of phonological change in deaf and hard of hearing children who use cochlear implants or hearing aids
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2014 (English)Manuscript (preprint) (Other academic)
Abstract [en]

Objective: The purpose of the present study was to examine cognitive abilities (i.e., working memory (WM), lexical access, phonological processing skills (PhPS), and letter knowledge) in deaf and hard of hearing (D/HH) children in relation to a reference group with normal hearing (NH) children pre intervention with a computer-assisted program that focused on phonological coding. A more specific purpose was to explore how cognitive abilities were associated to PhPS pre intervention and to phonological change post intervention in D/HH children in general, and specifically in D/HH children with weak initial PhPS.

Methods: Participants were thirty-two children using cochlear implants or hearing aids, or both in combination, and sixteen children with NH 5, 6 and 7 years of age. Children practiced with phonological coding 10 min per day for 4 weeks with support by their parents. Cognitive abilities were examined pre and post intervention.

Results: NH and D/HH children displayed a similar performance level on the majority of cognitive tasks, but the D/HH children demonstrated weaker lexical access and PhPS. A significant correlation between complex WM and PhPS pre intervention was only observed in D/HH children. Weak initial performance on one phonological processing task capturing both lower level and higher level auditory processing was the main significant predictor of phonological change in all D/HH children. In D/HH children with weak initial PhPS letter naming was associated with phonological change.

Conclusions: The associations between complex working memory and PhPS in D/HH children and the lack of such associations in children with NH may indicate that phonological processing skills require more cognitive resources in the D/HH children. Letter knowledge can act as a driving force for phonological change following intervention in D/HH children with weak PhPS.

Keyword
Deaf and hard of hearing, children, cochlear implants, hearing aids, phonological change, cognitive abilities
National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-108899 (URN)
Available from: 2014-07-11 Created: 2014-07-11 Last updated: 2014-07-11Bibliographically approved
3. Computer-assisted reading intervention with a phonics approach for children using cochlear implants or hearing aids
Open this publication in new window or tab >>Computer-assisted reading intervention with a phonics approach for children using cochlear implants or hearing aids
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2014 (English)In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 55, no 5, 448-455 p.Article in journal (Refereed) Published
Abstract [en]

The present study examines computer-assisted reading intervention with a phonics approach for deaf and hard of hearing (DHH) children in Sweden using cochlear implants or hearing aids, or a combination of both. The study included forty-eight children, 5, 6 and 7 years of age. Sixteen children with normal hearing (NH) served as a reference group. The first purpose of the study was to compare NH and DHH children’s reading ability at pre and post intervention. The second purpose was to investigate effects of the intervention. Cognitive and demographic factors were analyzed in relation to reading improvement. Results showed no statistically significant difference for reading ability at the group level, although NH children showed overall higher reading scores at both test points. Age comparisons revealed a statistically significant higher reading ability in the NH 7-year olds compared to the DHH 7-year olds. The intervention proved successful for word decoding accuracy, passage comprehension and as a reduction of nonword decoding errors in both NH and DHH children. Reading improvement was associated with complex working memory and phonological processing skills in NH children. Correspondent associations were observed with visual working memory and letter knowledge in the DHH children. Age was the only demographic factor that was significantly correlated with reading improvement. The results suggest that DHH children’s beginning reading may be influenced by visual strategies that might explain the reading delay in the older children.

Place, publisher, year, edition, pages
Wiley: 24 months, 2014
Keyword
Children, deaf and hard of hearing, cochlear implants, hearing aids, computer-assisted reading intervention, phonics approach
National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-108900 (URN)10.1111/sjop.12149 (DOI)000341908300007 ()25078707 (PubMedID)
Available from: 2014-07-11 Created: 2014-07-11 Last updated: 2017-12-05Bibliographically approved
4. Segmental and suprasegmental properties in nonword repetition: An explorative study of the associations with nonword decoding in children with normal hearing and children with bilateral cochlear implants
Open this publication in new window or tab >>Segmental and suprasegmental properties in nonword repetition: An explorative study of the associations with nonword decoding in children with normal hearing and children with bilateral cochlear implants
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2015 (English)In: Clinical Linguistics & Phonetics, ISSN 0269-9206, E-ISSN 1464-5076, Vol. 29, no 3, 216-235 p.Article in journal (Refereed) Published
Abstract [en]

The present study explored nonword repetition (NWR) and nonword decoding in normalhearing (NH) children and in children with cochlear implants (CIs). Participants were 11 children with bilateral CIs, 5:0-7:11 years (M = 6.5 yrs.), and 11 NH children, individually age-matched to the children with CIs. The purpose was twofold; to thoroughly describe aspects of repetition and decoding of novel words and to study possible associations between them. All children were assessed after having practiced with a computer-assisted reading intervention with a phonics approach during four weeks. Results showed that NH children outperformed children with CIs on the majority of aspects of NWR. The analysis of syllable length in NWR revealed that children with CIs made more syllable omissions than did the NH children, and predominantly in prestressed positions. Additionally, the consonant cluster analysis showed significantly more consonant omissions and substitutions in children with CIs suggesting that reaching fine- grained levels of phonological processing was particularly difficult for these children. No significant difference was found for decoding accuracy between the groups, as measured by percent nonwords and percent phonemes correctly decoded, but differences were observed regarding error patterns. Further, phoneme deletions and lexicalizing of nonwords occurred more often in children with CIs than in those with NH. The correlation analysis revealed that the ability to repeat consonant clusters in NWR had the strongest associations to nonword decoding in both groups.

Place, publisher, year, edition, pages
Informa Healthcare, 2015
Keyword
Nonword repetition, nonword decoding, children, normal hearing, cochlear implants
National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-108901 (URN)10.3109/02699206.2014.987926 (DOI)000349619700004 ()
Note

This research was funded by The Swedish Research Council for Working Life and Social Sciences, the Linneaus Centers HEAD at Linkoping University, and CCL - Cognition, Communication and Learning at Lund University.

Available from: 2014-07-11 Created: 2014-07-11 Last updated: 2017-12-05

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