EXPLORING LITERACY AND
LANGUAGE SKILLS OF
CHILDREN WITH HEARING
IMPAIRMENT
Susan Thomas Frank, M.A., CCC-S,
Gabrielle L. Gardner, B.S.
Department of Communication Disorders
College of Health Professions
Marshall University, Huntington, WV
INTRODUCTION
There is an ample amount of research involving language in the typically developing child as
well as in the child with Specific Language Impairment. However, only a small amount of
research exists involving language, literacy, and children with hearing impairment (Moeller et
al. 2007), and it is necessary to expand the knowledge base in this area.
Four children participated in this pre-experimental, exploratory study in which a trained
reader used dialogic reading during “circle time” instruction in an Auditory-Oral preschool.
Dialogic Reading (Whitehurst et al. 1994) is a style of shared book reading in which children
are active participants as opposed to passive listeners. Dialogic Reading has shown to be a
successful intervention in pre-school settings for increasing oral language skills (Justice et al.
2009). Four books were used; each book had a week dedicated to its repeated readings. Scripts
for prompts were developed for each book in an attempt to create uniformity. Each script
contained prompts requiring a morphological construct (regular past-tense) and non-evocative
print referencing.
OPERATIONAL DEFINITION OF
CONSTRUCTS
Dialogic Reading is a reading technique developed by G.J. Whitehurst (1994) consisting
of interactive, repeated book readings using various types of age-appropriate prompts to
engage the child in conversation about the book.
The Auditory-Oral Approach to education for children with hearing impairment has
two components: auditory, requiring the child to use their amplification devices in an
environment focused on oral language rather than gestural language; and oral, implying
that everyone in the setting uses oral language to communicate their wants and needs.
Emergent Literacy skills, as defined by Marie Clay (1991), are the foundational concepts
that a child needs before formal reading instruction can take place. They consist of book
awareness, print awareness, phonemic awareness, and oral language skills.
RATIONALE AND PURPOSE
This research project explored how pre-school children with hearing
impairment interacted with and responded to reading intervention
that emphasized the stimulation of pre-reading and language skills.
Another element involved was that of indirect language stimulation,
which refers to learning the elements of language in natural
interactions. Speech-language pathologists can apply this protocol in
a functional approach to therapy with children with language and
hearing impairment.
RATIONALE AND PURPOSE (CONT)
To expand the knowledge base on the
literacy development of pre-school
children with hearing impairment
To explore how children
with hearing impairment
respond to a dialogic
reading intervention
To examine whether morphologic
endings could be increased in children's
speech, using dialogic reading as the
implementation tool
RESEARCH QUESTION
How do pre-school children with hearing impairment interact
with and respond to reading intervention in a small group
setting that emphasizes the stimulation of emergent literacy and
language skills?
ENVIRONMENT
The dialogic reading sessions occurred in the main classroom of an auditoryoral pre-school located on the campus of Marshall University, Huntington,
WV. This area was large, rectangular, and well-lit, painted light yellow with
educational words and illustrations placed on the walls. One wall contained a
two-way mirror for observation purposes. Toys and other objects in the
classroom had word labels. There were small rectangular child-proof
windows with curtains.
The pre- and post-testing took place in a smaller, well-lit therapy room
adjacent to the classroom.
PARTICIPANTS
The children involved in the study were recruited via
convenience sampling; they were enrolled in the auditory-oral
pre-school program at Marshall University. Other inclusion
criteria required the children to have a documented hearing loss
for which they wore amplification. The children wore a
combination of hearing aids and cochlear implants. The
researchers met individually with the parents of each child
before the study to inform them about the study and to obtain
consent.
PARTICIPANT PROFILE
Age At Study
Degree of Loss Age of Initial
Aiding
Type of
Amplification
Attendance
Schedule
Child
One: T
5:4
Profound
Bilateral
4 MO
CI – RE;
HA – LE
12/12
sessions
Child
Two: E
4:10
Moderately
severe –
profound
bilateral
9 MO
Bilateral
HAs
12/12
sessions
Child
Three: L
2:3
Profound
Bilateral
8 MO
Bilateral
CIs
6/12
sessions
Child
Four: P
2:5
Profound
Bilateral
4 MO
CI – RE
3/12
sessions
MATERIALS
Four pieces of children’s literature were chosen for use in the study.
Two well-known children’s books – Corduroy (Freeman, 1968) and
Harry the Dirty Dog (Zion, 1976) – were previously used in work
involving children and literacy (McGregor, 2000; Miller, 2006). The
other two were chosen by the second author for the use of regular
past-tense action. Each book had a corresponding script which
contained the prompts for dialogic reading as well as non-evocative
print referencing (e.g. tracing text directionality, front/back book
orientation).
PROCEDURES
1.
2.
3.
4.
Assent was obtained for each child by the research staff.
The children were pre-tested using color photocopies of illustrations from
the books. The pictures were presented individually and the child was
asked “What did _______ do here?” to elicit a past-tense response. The
Preschool Word and Print Awareness assessment tool (Justice, Bowles, and
Skibbe, 2006) was also administered to the children to view the knowledge
of concepts of print and book awareness.
The dialogic reading intervention took place across a span of four weeks.
One book was scheduled for each week and was read three times, at the
same time each morning, during “circle time”. Scripts for each book were
implemented during the reading. The children sat in an arc facing the
reader; the classroom teacher, the pre-school speech-language pathologist,
and a graduate assistant also sat with the children during this time. The
reading sessions ranged in time from ten to twenty minutes.
The children were post-tested with the same color photocopies from the
pre-test, using the same prompts.
Number of Utterances
T's Exchanges Across Readings
60
50
40
30
20
10
0
0
1
2
3
4
5
6
7
8
9
10
11
12
Reading Session
T attended every reading session
and was very active in the
intervention experience. T was
also very observant of the
repeated readings, occasionally
becoming bored and inquiring
“Do we have to do it again?” but
continued to participate and
retell the stories with the
reader.
Number of Responses
T's Responses of Regular Past Tense
4
3
2
1
0
Four
Four
Two
Four
Four
Two
Two
Two
Number of Verbal Prompts
Three
Four
Four
Three
Number of Utterances
L's Exchanges Across Readings
35
30
25
20
15
10
5
0
0
1
2
3
4
5
6
7
8
9
10
11
12
L, the youngest of the
participants, was being
transitioned into the auditoryoral program at the time of the
study. She attended well to
reading sessions but was
occasionally distracted by the
video camera or the other
children.
Reading Session
Number of Responses
L's Responses of Regular Past Tense
4
3
2
1
0
Four
Four
Two
Four
Number of Verbal Prompts
Four
Three
Number of Utterances
P’s Exchanges Across Readings
P was being transitioned into
the auditory-oral program at the
time of the study and only
attended three sessions. P used
nods and gestures to minimally
interact with the reader.
5
4
3
2
1
0
0
1
2
3
4
5
6
7
8
9
10
11
12
Reading Sessions
Number of Responses
P's Responses of Regular Past Tense
4
3
2
1
0
Four
Four
Number of Verbal Prompts
Four
Number of Utterances
E's Exchanges Across Readings
25
20
15
10
5
0
0
1
2
3
4
5
6
7
8
9
10
11
12
Number of Responses
Reading Sessions
E attended every reading
session; however, behavior was
a recurring issue. E would
frequently answer questions
with “I don’t know” – a habit
observed during normal
instruction time. E also would
point to pictures and pretended
to read to the classmates on
three occasions after the reader
finished.
E's Response of Regular Past Tense
4
3
2
1
0
Four
Four
Two
Four
Four
Four
Two
Three
Number of Verbal Prompts
Three
Four
Four
Three
DATA COLLECTION
AND ANALYSIS
The research staff collected data in the forms of observations, field
notes, audio recordings, and video recordings. The audio and video
recordings were transcribed by the second author. Both authors
coded the children’s responses for occurrences of the following:
y
y
y
y
y
Imitation of utterances said by the reader, either spontaneous or elicited
Recall of events in the book, either spontaneous or elicited
Concepts of print awareness and book awareness
Conversation that distanced from the story but was still related in some way
Dialogue about the story that did not fit the above criteria
FINDINGS
|
Children with hearing impairment responded positively to
dialogic reading.
|
Children with hearing impairment increased their frequency of
response with regular and consistent exposure to the
intervention.
|
Children who sat closer to the reader answered more questions
than children who sat at a distance from the reader.
|
Children wanted to physically interact with the book during
the reading sessions by pointing, touching, and turning the
pages.
LIMITATIONS
|
Attendance of participants
|
Wide range of ages and developmental levels
|
Variance of degree of correction of hearing loss
|
No knowledge of book use in the home setting
|
Amount of research leading up to study
|
No baseline period
IMPLICATIONS AND
FUTURE DIRECTIONS
Children with hearing impairment can meaningfully engage in the
dialogic reading process similar to typically developing peers.
Future studies of children with hearing impairment and dialogic
reading should:
y Evaluate the number of books in the home and the frequency of shared book
reading
y Examine the efficacy of using dialogic reading to target a specific language
goal during intervention
y Explore the efficacy of group versus individual dialogic reading
y Follow up on the impact of dialogic reading on concepts of print
REFERENCES
Blake, J. (1992). Wriggly pig. Tambourine Books.
Freeman, D. (1968). Corduroy. Viking Juvenile .
Ginsburg, M. (1974). Mushroom in the rain. Macmillan Publishing Company.
Justice, L. M., Bowles, R. P., & Skibbe, L. E. (2006). Measuring preschool attainment of print-concept knowledge: A
study of typical and at-risk 3- to 50 year-old children using item response theory. Language, Speech, and Hearing
Services in Schools, 37, 224-235.
Justice, L. M., Kaderavek, J. N., Sofka, A., & Hunt, A. (2009). Accelerating preschoolers’ early literacy development
through classroom-based teacher-child storybook reading and explicit print referencing. Language, Speech, and
Hearing Services in Schools, 40, 67-85.
Lovelace, S. & Stewart, S. R. (2007). Increasing print awareness in preschoolers with language impairment using nonevocative print referencing. Language, Speech, and Hearing Services in Schools, 38, 16-30.
McGregor, K.K (2000). The development and enhancement of narrative skills in a pre-school classroom: Towards a
solution to clinician-client mismatch. American Journal of Speech Language Pathology, 9 57-71.
Miller, C.A. (2006). Developmental relationships between language and theory of mind. American Journal of Speech
Language Pathology, 15, 142-154.
Moeller, M. P., Tomblin, J. B., Yoshingata-Itano, C. Connor, C. M., & Jerger, S. (2007). Current state of knowledge:
Language and literacy of children with hearing impairment. Ear and Hearing, 28, 740-753.
Whitehurst, G. J., Epstein, J. N., Angell, A. L., Payne, A. C., Crone, D. A., & Fischel, J. E. (1994). Outcomes of an
emergent literacy intervention in head start. Journal of Educational Psychology, 86, 542-555.
Zion, G. (1976). Harry the dirty dog. HarperCollins.
Contact Information:
Susan Thomas Frank: [email protected]