Hearing Status, Language Modality, and Young Children's Communicative and Linguistic Behavior
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Updated: Aug 21, 2026

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
Johanna G. Nicholas1, Ann E. Geers
1The authors are at the Center for Applied Research in Childhood Deafness at Central Institute for the Deaf. This study was supported by Grant No. DC01259Center for Applied Studies of Childhood Deafness and Adult Aural Rehabilitation, Central Institute for the Deaf, 4560 Clayton Ave., St. Louis, MO 63110. jnicholas@cid.wustl.edu
Abstract:
This study examined early pragmatic skill development in a group of 38 children with severe or profound hearing loss between 1 and 4 years of age who were enrolled in a simultaneous communication (SC) approach to language learning. Both their use of intentionally communicative acts and their use of language were studied in an analysis of 30-min play sessions between a child and the primary caregiver. Results were compared with previously published data from two age-matched groups: 38 deaf children who were enrolled in oral communication (OC) programs and 84 normally hearing (NH) children. All groups showed a significant improvement with age in the communicative behaviors measured; therefore, the overall trend was toward growth-in all age groups-even when the rates of growth differed. By age 3 years, a pattern of communicative function use had emerged in all three groups. Patterns exhibited by deaf children in the SC and OC groups were similar to each other and to younger NH children but dissimilar to NH age mates. Although the use of signed input by normally hearing parents and teachers did not serve to ameliorate the profound effects of hearing loss on communication development in SC children, it did provide some early advantages. The children in SC groups did not exhibit an advantage over children in OC groups in their overall frequency of communication or the breadth of their vocabulary but they began using words earlier and used mature communicative functions significantly more often. Although children in the OC groups did not exhibit a significant advantage in the overall amount of speech used, they showed an advantage in the breadth of their spoken vocabulary in a conversational setting. Implications for early intervention programming are discussed.
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