Assistive Technology Aids Language Learning in Hearing-Impaired Children

By Lisa Rapaport

January 19, 2021

(Reuters Health) – Children who are deaf or hard of hearing can learn to express themselves with longer phrases, take more turns in conversations, and develop more words in their vocabulary when they receive assistive speech technology, a clinical trial found.

Researchers randomly assigned 41 children aged 3 to 12 years with mild to profound bilateral hearing loss to receive usual care for speech and language therapy on its own, or augmented with a technology-assisted language intervention.

The children who used the assistive technology experienced significantly bigger gains in the length of phrases they used to express themselves than kids who didn't get this support (beta 0.91 vs 0.15, respectively). In addition, children also made significantly larger improvements in conversational turn-taking (beta 1.21 vs 0.26) and in the vocabulary size demonstrated in conversation (beta 11.04 vs 2.65).

"Children who are deaf or hard of hearing require robust, multi-modal support to develop their potential, which goes well beyond simply restoring hearing with a hearing aid or cochlear implant or traditional speech/language therapy," said Dr. Richard Rosenfeld, chairman of otolaryngology at SUNY Downstate Health Sciences University in New York City.

"Adding visual and auditory cues or feedback to speech therapy and engaging the child with an interactive tablet device, as was done in this study, would enhance the efficacy of therapy," Dr. Rosenfeld, who wasn't involved in the study, said by email.

Study participants randomized to receive assistive technology used the TouchChat HD-ACC with WordPower language program on iPads. This software offers visuals to help children understand abstract linguistic concepts, provides voice output, and also gives kids a consistent model for verbalization.

The group assigned to this intervention had weekly hour-long sessions over a total of four six-week cycles alternating speech and language therapy with licensed providers and self-guided sessions at home.

After 24 weeks, children in the control group receiving usual care didn't experience significant improvements in mean receptive or expressive language abilities. But kids who used the assistive technology made significant improvements in both domains.

Limitations of the study include the small size, as well as the lack of data on the effectiveness of the intervention based on kids' age, the study team notes in Pediatrics. The authors also lacked data on parent engagement at home, and parental interactions can independently influence language development in children, they note.

Even so, the results offer fresh evidence that visual cues can aid language learning in children who are hard of hearing, said lead author Jareen Meinzen-Derr of the Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, in Ohio.

"With spoken language, messages are said or spoken out loud and then disappear, and children who are hard of hearing sometimes struggle to catch and process all of what is said," Meinzen-Derr said by email. "As a result, they may have difficulty developing language skills in the same way as their hearing peers."

Using an iPad with augmentative and alternative communication software enabled children to look at the words, message or phrase as many times as needed, and work with the words in a way that is different than listening alone, Meinzen-Derr added.

"By seeing a visible and stable representation of language and being able to put these words into sentences, this intervention seemed to help children build stronger language skills," Dr. Meinzen-Derr said.

SOURCE: Pediatrics, online January 15, 2021.