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ABSTRACT
Children who are deaf and hard of hearing (DHH) often demonstrate pragmatic language difficulties which can impact academic and social outcomes. This randomized control trial for DHH children, ages 3–12 years, explored the Technology-Assisted Language Intervention (TALI), incorporating augmentative and alternative communication technology (AAC) into traditional speech/language therapy, compared to treatment-as-usual (TAU) to determine impact on pragmatics. Pragmatic outcome measures included parent reported Pragmatics Profile of the CELF-5 (for children age ≥5 years) and CELF-P Descriptive Pragmatics Profile (for children <5 years) in addition to parent reported Social and Communication domains of the Vineland Adaptive Behavior Scales,Third Edition (VABS). Over 24 weeks, children ≥5 years in the TALI made significantly more progress (increase in raw scores) on the Pragmatics Profile compared to children in TAU (12.7 points vs. −6.0 points; p = 0.04) and also showed significant gains on two of the three subscales. For children ≥5 years, no significant VABS changes were seen in either intervention group. For children <5 years, there were no statistically significant differences in growth on the CELF-P total pragmatics raw score or on any subdomain. However, children in TALI had significant increases in the mean VABS Communication (86.7–99.1) and Social domain standard scores (91.8–97.4;p = 0.01), while gains for children in TAU on the Communication and Social domain standard scores were not statistically significant. These promising results support the need for additional research exploring the effectiveness of AAC supported speech/language therapy to enhance DHH children’s pragmatic language skills.
Trial registration: ClinicalTrials.gov identifier: NCT02998164.
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No potential conflict of interest was reported by the author(s).
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Notes on contributors
Deborah Mood
Deborah Mood is a psychologist at Children’s Hospital Colorado in Developmental and Behavioral Pediatrics, Department of Pediatrics at the University of Colorado- Anschutz. Her clinical efforts and research interests involve supporting DHH children with developmental disabilities and their families. She is also faculty with the JFK Partners/Developmental Pediatrics Leadership in Education in Neurodevelopmental Disabilities (LEND) training program. Dr. Mood is the lead CU Anschutz site investigator of the Technology Assisted Language Intervention team.
Rose Sheldon
Rose Sheldon is a speech-language pathologist at Cincinnati Children's Hospital Medical Center, Division of Developmental and Behavioral Pediatrics. She specializes in providing evaluations and therapy for children with developmental disabilities and provides support for children who have augmentative and alternative communication (AAC) needs. She is also a member of the clinical research team for Technology-Assisted Language Intervention (TALI) for children with hearing loss, conducting evaluations and providing AAC-based interventions for children who have hearing loss that are in the study.
Meredith Tabangin
Meredith Tabangin is a quantitative epidemiologist at Cincinnati Children’s Hospital Medical Center in the Division of Biostatistics and Epidemiology. She is a member of the Technology-Assisted Language Intervention (TALI) research team and collaborates on other research studies related to outcomes of children with hearing loss.
Susan Wiley
Susan Wiley is a developmental pediatrician at the Cincinnati Children’s Hospital Medical Center Division of Developmental and Behavioral Pediatrics. She has a clinical and research interest in children who are Deaf/Hard of Hearing Plus. She is one of the American Academy of Pediatrics Liaisons to the Joint Committee on Infant Hearing and is on the advisory councils of the Ohio Department of Health Universal Newborn Screening Advisory Council, and on the Advisory committee for the Ohio Center for Deaf-Blind Education.
Jareen Meinzen-Derr
Jareen Meinzen-Derr is an epidemiologist at Cincinnati Children’s Hospital Medical Center, Division of Biostatistics and Epidemiology and the co-Director of the Center for Clinical and Translational Science and Training. Her research focuses on optimizing outcomes for children who are Deaf or Hard of Hearing, including children with developmental disabilities. She is the lead investigator of the Technology-Assisted Language Intervention research team. She sits on the Ohio Department of Health Universal Newborn Screening Advisory Council.