Early communication intervention for deaf/hard of hearing toddlers: Long-term language and literacy outcomes

PROJECT SUMMARY Hearing loss is one of the most prevalent congenital conditions. Recent advances in early detection and technology have contributed to significant improvement in long-term outcomes for deaf/hard of hearing (DHH) children. Despite this progress, language and literacy outcomes for school-age DHH children are inconsistent and many DHH children do not “catch up” to their hearing peers. Closing this gap requires the implementation of effective early communication interventions. Yet, until recently, there was a significant paucity of research on early communication interventions for DHH children. Parent-implemented communication interventions (PICTs), which involve teaching parent strategies to enhance their child’s language learning experiences, are a promising form of early intervention for DHH toddlers. During the previous project period, we completed the first large-scale randomized clinical trial of a PICT for DHH toddlers. Results suggest that PICT is an efficacious approach to supporting DHH toddlers’ communication development. Parents learned to effectively implement communication support strategies that align with their DHH child’s language learning needs and, as a result, child communication outcomes improved. Recent analyses also suggest that the positive effects of the intervention continue as children transition to preschool, highlighting the potential for long-lasting impact. The intervention’s long-lasting effect is likely due the benefits of the parent-implemented service delivery model, which increases the dosage of intervention during a period of heightened neuroplasticity and equips parents with tools to continue to support their child’s development well beyond the intervention period. The proposed project will be the first large- scale evaluation of the long-term effects of an early communication intervention on school-age language and literacy outcomes for DHH children. During the previous project period, 96 parent-child dyads enrolled, and 88 dyads remain involved in the clinical trial and consented to contact for a follow-up research study. During the proposed project period, we will examine the long-term effects of the intervention on school-age outcomes and characterize the intermediary mechanisms of these effects. We consider not only how early communication interventions affect subsequent child outcomes, but also how involving parents early in their child’s development may lay the foundation for sustained parent engagement as children transition to school-based services. In order to further understand the heterogeneity of school-age outcomes for DHH children, we will leverage this wealth of longitudinal data to identify early communication profiles associated with persistent language and literacy difficulties for school-age DHH children. Taken together, we plan to integrate child and parent outcomes to fully characterize how early language learning experiences shape long-term language and literacy outcomes. Understanding the pathways through which early interventions affect DHH children’s developmental trajectory will have widespread implications for research and clinical practice.