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Fresh science and pioneering practice
144
JCPSLP
Volume 17, Number 3 2015
Journal of Clinical Practice in Speech-Language Pathology
Michelle Saetre-
Turner (top), Cori
Williams (centre),
and Michelle
Quail
THIS ARTICLE
HAS BEEN
PEER-
REVIEWED
KEYWORDS
HEARING
IMPAIRMENT
LANGUAGE
DEVELOPMENT
LANGUAGE
ENVIRONMENT
ANALYSIS
(LENA)
development, such as intrusiveness and unresponsiveness,
as an “intuitive response to the effects of hearing
impairment on infant behaviour” (Lam & Kitamura, 2010,
p. 545). The language outcomes of children who are D/HH
continue to fall behind normally hearing (NH) peers, despite
early identification of hearing loss, early intervention, and
improvements in hearing technology (Vohr et al., 2014).
There have been relatively few investigations regarding the
quality of the home language environment (HLE) involving
children who are D/HH, particularly compared with research
exploring the quantity of language received. This is despite
studies voicing the need for such explorations (Aragon &
Yoshinaga-Itano, 2012; Vohr et al., 2014).
Language development in the home
language environment
Children learn language by attaching meaning to the
individual words and sounds they have segmented when
hearing the speech stream (Chiat, 2001). The number of
words and communicative opportunities a child is exposed
to significantly impacts language acquisition (Leffel &
Suskind, 2013; Zimmerman et al., 2009), with talkative
parents providing more opportunities for mapping meaning
onto words (VanDam et al., 2012). Impaired auditory
processing has a flow-on effect on the ability to store,
understand, and produce language (Claessen, Leitão, Kane
& Williams, 2013). As a result, children who are D/HH often
have marked language delays, influenced by factors
including the severity of hearing loss, age of amplification or
implantation, and socioeconomic factors such as parental
education (Szagun & Stumper, 2012). In terms of typical
language acquisition, a review of the literature by Suskind et
al. (2013) noted the relationship between the quality of a
child’s language exposure and their linguistic outcomes and
academic success later in life. Qualitative features of the
HLE, such as the complexity of speech to the child, the
responsiveness of the caregivers, and the nature of
caregiver–child interactions, were associated with academic
performance (Suskind et al., 2013).
Caregiver-directed interventions stem from research
highlighting the impact of the HLE on language outcomes
(Vigil, Hodges & Klee, 2005). Current interventions, such
as the Hanen Parent Training Program (Manolson, 1992),
involve teaching caregivers strategies that facilitate
language development. This includes an interaction style
that is less directive and more responsive to their child’s
communication. The program appreciates that caregivers
have a unique opportunity to cultivate their child’s
language learning through supportive communicative
This pilot study investigated differences in
the quality and quantity of caregiver–child
interaction in the home language environment
of children who are deaf or hard of hearing
(
N
= 5) and normally hearing (
N
= 5) children.
The language environment was analysed from
audio recordings collected using the Language
Environment Analysis (LENA) system on seven
measures of interaction quality and three
measures of language quantity. Measures of
interaction quality were the number of:
successful child and caregiver initiations,
connected utterances, failed utterances,
behavioural directives, caregiver expansions,
and the ratio of successful child to caregiver
initiations. Measures of language quantity
were adult word count, conversational turn
count, and child vocalisation count. This
study is founded on emergentism theory, with
the outcome measures selected to indicate
the hypothesised relationship between
hearing loss and the language environment.
The interaction quality was less supportive of
language development in the deaf or hard of
hearing group on all but two measures: the
number of failed utterances and the ratio of
successful child to caregiver initiations.
Language quantity was not significantly
different between the groups. The findings
have implications for intervention strategies
for children who are deaf or hard of hearing,
and support further analysis of the home
language environment.
C
aregivers are critical facilitators of a child’s cognitive,
linguistic, and social development (Vohr, Topol,
Watson, St Pierre & Tucker, 2014). A hearing
loss disrupts the typical trajectory of communication
development, increasing the importance of an environment
that is supportive of language growth (VanDam, Ambrose
& Moeller, 2012). Yet, it is noted that caregivers of children
who are deaf or hard of hearing (D/HH) display behaviours
traditionally viewed as non-supportive of language
Caregiver–child interaction in
children who are deaf or hard
of hearing and children who are
normally hearing: Preliminary data
Michelle Saetre-Turner, Cori Williams, and Michelle Quail