There is little information on speech and language development in pre-school children with mild, moderate or severe hearing impairment. The primary aim of the study is to establish a reference material for clinical use covering various aspects of speech and language functions and to relate test values to pure tone audiograms and parents' judgement of their children's hearing and language abilities.
Nine speech and language tests were applied or modified, both classical tests and newly developed tests. Ninety-seven children with normal hearing and 156 with hearing impairment were tested. Hearing was 80 dB HL PTA or better in the best ear. Swedish was their strongest language. None had any additional diagnosed major handicaps. The children were 4-6 years of age. The material was divided into 10 categories of hearing impairment, 5 conductive and 5 sensorineural: unilateral; bilateral 0-20; 21-40; 41-60; 61-80 dB HL PTA. The tests, selected on the basis of a three component language model, are phoneme discrimination; rhyme matching; Peabody Picture Vocabulary Test (PPVT-III, word perception); Test for Reception of Grammar (TROG, grammar perception); prosodic phrase focus; rhyme construction; Word Finding Vocabulary Test (word production); Action Picture Test (grammar production); oral motor test.
Only categories with sensorineural loss showed significant differences from normal. Word production showed the most marked delay for 21-40 dB HL: 5 and 6 years p
OBJECTIVE: In Sweden, there has previously been no normalised test material for the evaluation of language development in individual hearing-impaired children, and for the assessment of various methods of auditory habilitation. The purpose of the present study was to compose, apply and evaluate a test for language development in hearing-impaired children, and to establish the first set of reference values related to age, sex, type and degree of hearing impairment. METHODS: A test consisting of nine subtests was assembled and developed for, and subsequently applied to, hearing-impaired children in the age range 4-6 years. The inclusion criteria were a pure tone average of 80 dBHL or less and oral language (Swedish) as the first language. Two hundred and eleven hearing-impaired children and 87 normal hearing control children were tested. RESULTS: The results show that: (1) children with hearing impairment-also unilateral-have a delayed language development; (2) the delay is greater in children with larger losses and tends to decrease with increasing age; (3) 6-year-olds with hearing loss greater than 60 dB have not reached the level of the control group; (4) no difference between right- or left sided deafness with respect to language development was observed; (5) a reference material, applicable during clinical assessment, was established for the most common types of hearing impairment. CONCLUSIONS: The test designed gave graded measures of important aspects of language development in hearing-impaired children. The results merit further application of the test material.