Phonological skills and executive function in Mandarin-speaking children aged 3-5 with hearing impairment

The study investigates phonological skills and executive function (EF) in prelingually hearing-impaired (HI) children aged 3-5, and examines the associations between these domains and related factors. Seventy five HI preschoolers and 75 age-matched typically developing (TD) children participated in the study. All underwent assessments of working memory, inhibitory control, and cognitive flexibility. Phonological recognition was assessed using the Phonological Equilibrium Recognition Scale, while phonological production was evaluated with the Chinese Vocabulary List for Phonetic Ability. HI children exhibited significant delays in both phonological skills and EF relative to TD peers. Phonological performance was associated with hearing status and age, whereas EF performance was primarily linked to age. Correlation and regression analyses revealed that phonological production was significantly associated with multiple EF components. Phonological recognition was primarily related to inhibitory control and hearing thresholds. Critically, regression models showed a pattern of unique interconnections: phonological production was independently associated with working memory and inhibitory control, which were also significantly associated with phonological skills. Preschool-aged HI children show co-occurring deficits in phonological processing and executive function, which are closely associated in a reciprocal pattern. These findings suggest the potential value of early integrated interventions targeting both phonological and cognitive skills.