importancia para minimizar el error tipo 1 porque todas las pruebas se
correlacionaron entre sí. Se realizaron pruebas Post Hoc (HSD de
Tukey) cuando el efecto principal de Grado o Grupo fue significativo. Se
realizaron pruebas de efectos simples para examinar el efecto del
Tiempo para cada Grado o Grupo cuando hubo interacción Tiempo x
Grado o Tiempo x Grupo. También calculamos los tamaños del efecto (
gramo; Hedges, 2007) como la diferencia media estimada del modelo
ajustada por el error residual en otoño. Similar a la d de Cohen, la g de
Hedges es el número de desviaciones estándar basado en el modelo
que difieren dos medidas (controlando todos los demás efectos en el
modelo).
Sintaxis expresiva en inglés (CELF-WS)
los niños tenían una puntuación estándar promedio de 2,7, más de 2 DE por
debajo de la media normativa. Solo el 11% de los niños puntuaron dentro de
1 DE de la media normativa. Los niños del grupo de solo habla mostraron
mejoras desde el otoño (media = 2,7) hasta la primavera (media = 3,5,gramo
=0.28), pero no hubo efecto principal de Grupo. La Figura S1 muestra que los
niños aumentaron el número total de elementos correctos desde el otoño
hasta la primavera, pero ambos grupos obtuvieron puntajes cercanos al
piso.
Solo hablado y bimodal
Sintaxis receptiva de ASL
del 61,9 al 69,9% correcto,gramo=0,53. Los alumnos de kindergarten obtuvieron una
puntuación más baja (media = 56,0 %) que los de primer grado (media = 65,0 %,gramo=
0,60) que puntuaron más bajo que los alumnos de segundo grado (media = 79,3%,gramo=
0.90.) Como es evidente enTabla 2y la Figura S1, las puntuaciones de los niños en los
grupos bimodales y de solo signo fueron muy similares y mostraron una mejora constante
desde el otoño hasta la primavera y entre los grados. Con un promedio de 82.0% correcto
en la primavera, muchos alumnos de segundo grado estuvieron cerca del techo.
A lo largo del año escolar, las puntuaciones aumentaron
Resultados
Los grupos puntuaron en el rango promedio para el CI no verbal sin
diferencias de grupo. Como era de esperar, los grupos diferían en sus
habilidades del habla (vertabla 1). Las tablas S3–S14 (disponibles en
línea) presentan los resultados estadísticos de los ANOVA y las pruebas
de seguimiento. Debido al volumen y la complejidad de los datos, y
para mejorar la legibilidad, resumimos estos resultados en Tabla 2.
Describimos sólo aquellos efectos que fueron estadísticamente
significativos.
Resumen de resultados de idioma
sintaxis expresiva en inglés, los niños DHH se retrasaron en comparación con las normas
de la prueba. El vocabulario fue un punto fuerte en comparación con el conocimiento de la
sintaxis de los niños. La sintaxis expresiva en inglés se retrasó gravemente y casi todos los
niños obtuvieron calificaciones muy por debajo del rango promedio. En general, los niños
mostraron mejoras en las puntuaciones estándar desde el otoño hasta la primavera,
aunque los tamaños del efecto fueron pequeños, con la excepción del aprendizaje de
vocabulario por parte de los niños de jardín de infantes (gramo=0,46). Las puntuaciones
estándar fueron similares en todos los grados. Los niños que solo hablan y los bimodales
obtuvieron puntajes similares en las pruebas de vocabulario y sintaxis. Los niños que solo
usan señas obtuvieron puntajes de vocabulario similares a los de los otros dos grupos,
pero puntajes más bajos en la sintaxis del inglés receptivo (gramo=0,45–0,50). En la
prueba de ASL, los niños bimodales y de solo señas mostraron una mejora notablemente
similar y constante a lo largo del tiempo y el grado.
Sobre vocabulario y receptivo y
Idioma
Tabla 3muestra las medias de la puntuación del idioma, las SD y el porcentaje de
puntuación de la muestra dentro del rango promedio. Las tablas S2–S4 muestran
los resultados del modelo.
Vocabulario (EOWPVT)
La muestra total obtuvo una puntuación estándar de 83,2, con un 44 % de niños
con una puntuación dentro o por encima de 1 SD de la media normativa (es decir,
por encima de 85). A lo largo del año escolar, las puntuaciones estándar de
vocabulario para la muestra total aumentaron de 81,2 a 84,9,gramo=0.25. Los
alumnos de kínder aumentaron sus puntajes de 80.8 a 86.2,gramo=0.46. Los
alumnos de primer grado aumentaron sus puntajes de 81.9 a 85,gramo=0.19. En
segundo grado, las puntuaciones estándar fueron planas. Por lo tanto, las
ganancias de vocabulario a lo largo del año escolar fueron mayores que las
ganancias esperadas en la muestra normativa en jardín de infantes y primer grado
y similares a las ganancias esperadas en la muestra normativa en segundo grado.
A pesar de las mejoras ocurridas durante el año escolar, no hubo efectos
significativos para el grado. Los niños de los tres grados comenzaron el año
escolar con puntajes estándar de alrededor de 80. El gráfico de puntajes
brutos que se muestra en la Figura S1 (disponible en línea) muestra un
aumento continuo en la cantidad de palabras correctas con el tiempo (es
decir, de otoño a primavera y de grado al grado) y también muestra que el
crecimiento fue similar para los tres grupos. La única excepción fueron los
niños de jardín de infantes que solo usaban señas y que comenzaron con
puntajes bajos de vocabulario, pero se pusieron al día con los otros dos
grupos al final de su año de jardín de infantes.
Lectura
Tabla 4muestra las medias de la puntuación estándar de lectura, las SD y el
porcentaje de puntuación de la muestra dentro del rango medio. Las tablas S5–S7
muestran los resultados del modelo.
Lectura de una sola palabra (WJ Word ID)
La muestra total obtuvo una puntuación media de 91,2 con el 67 % de los niños
con una puntuación dentro de 1 SD de la norma (en o por encima de 85). Los
alumnos de jardín de infancia (media = 95,7) obtuvieron puntajes más altos que los
de segundo grado (media = 84,9,gramo=0,65). Solo los niños de kindergarten
aumentaron significativamente sus puntajes desde el otoño (media = 94.5) hasta la
primavera (media = 97.1),gramo=0.14. En general, sólo hablado (media = 96,1,
gramo=0,65) y niños bimodales (media = 92,9,gramo=0,45) puntuaron más alto
que los niños de solo signos (media = 85,9), sin diferencias entre los dos primeros
grupos. Los niños que solo hablan aumentaron sus puntuaciones estándar desde
el otoño (media = 94,7) hasta la primavera (media = 97,6,gramo=0,15). Las
puntuaciones W aumentaron para los tres grupos (ver Figura S2). Sintaxis
Sintaxis receptiva en inglés (TACL)La muestra total tuvo una puntuación
estándar promedio de 5,8 con el 37% de los niños dentro de 1 SD de la
media normativa. Los puntajes aumentaron de 5.6 a 6.0 a lo largo del año
escolar,gramo=0.17. Niños en el solo hablado (media = 6.2, gramo=0,45) y
bimodal (media = 6,4,gramo=0,50) los grupos puntuaron de manera similar
entre sí pero más alta que los niños en el grupo de solo signos (media = 4,9).
La figura S1 (en línea) muestra que cada grupo aumentó el total de
elementos correctos con el tiempo.
Lectura sin palabras (WJ Word Attack)
La muestra total obtuvo una puntuación media de 82,2 con un 46 % de niños con
una puntuación dentro de 1 DE (85 o más). Las puntuaciones estándar
disminuyeron desde el otoño (media = 83,5) hasta la primavera (media = 81,0,
gramo=0,19). Los niños de kindergarten (media = 93.2) tenían un estándar más alto
Tabla 3Medias y desviaciones estándar por tiempo, grado y grupo en medidas de lenguaje
Prueba Puntaje Grupo Jardín de infancia
Caer Primavera
METRO(DAKOTA DEL SUR) METRO(DAKOTA DEL SUR)
Primer grado
Caer Primavera
METRO(DAKOTA DEL SUR) METRO(DAKOTA DEL SUR)
Segundo grado
Caer Primavera
METRO(DAKOTA DEL SUR) METRO(DAKOTA DEL SUR)
Total %≥85/%≥7
METRO(DAKOTA DEL SUR)
Vocabulario
(EOWPVT)
Estándar
puntaje
Hablado
bimodal
Firmar
Total
%≥85
Hablado
bimodal
Firmar
Total
%≥7
Hablado
bimodal
Total
%≥7
bimodal
Firmar
Total
82,8 (16,1)
82,1 (13,4)
76,6 (16,3)
80,8 (15,4)
37%
6,5 (2,9)
6.6 (3.1)
4.7 (2.9)
5.9 (3.1)
43%
3.1 (2.6)
2,5 (2,9)
2.9 (2.7)
11%
51,7 (15,3)
50,6 (18,5)
51,1 (17,0)
85,5 (16,6)
86,2 (14,8)
86,9 (16,6)
86,2 (15,9)
80,4 (12,5)
83,8 (11,2)
81,2 (18,2)
81,9 (14,6)
82,8 (13,1)
86,5 (15,2)
86,0 (17,7)
85,3 (15,6)
79,5 (10,2)
78,2 (14,6)
84,0 (11,3)
81,0 (12,2)
78,9 (11,2)
81,7 (14,9)
85,4 (11,3)
82,6 (12,7)
82,3 (14,2)
83,5 (14,1)
83,6 (15,8)
83,2 (14,8)
43%
44%
45%
55%
6.8 (3.2)
7,0 (3,2)
4.8 (2.8)
6.2 (3.2)
44%
3.9 (3.4)
2.3 (2.2)
3.2 (3.0)
dieciséis%
36%
5,5 (2,6)
6.1 (2.6)
4.4 (2.6)
5.2 (2.7)
34%
2.2 (2.1)
2.1 (2.5)
2.1 (2.3)
6%
49%
5,9 (2,6)
5.8 (2.8)
5.2 (2.7)
5.6 (2.7)
34%
3.2 (2.9)
2.2 (2.6)
2.6 (2.7)
11%
41%
5,7 (2,5)
6,0 (2,9)
5.1 (2.8)
5,5 (2,7)
29%
2.6 (2.2)
2.1 (3.1)
2.3 (2.7)
7%
41%
6.7 (2.7)
6.8 (2.4)
5.7 (2.6)
6.3 (2.6)
37%
3.2 (2.4)
2.3 (3.0)
2.7 (2.8)
14%
44%
6.2 (2.9)
6.4 (2.9)
4,9 (2,7)
5,8 (2,9)
37%
3.1 (2.8)
2.3 (2.7)
Ing. rec.
sintaxis (TACL)
Estándar
puntaje
40%
47%
28%
Ing. Exp.
sintaxis
(CELF-WS)
Estándar
puntaje
13%
9%
2.7 (2.7)
11%
64,5 (16,5)
66,9 (19,3)
65,8 (18,1)
Rec. de ASL
sintaxis (Schick,
2013)
Por ciento
correcto
60,4 (14,8)
61,4 (17,9)
60,9 (16,4)
60,3 (14,5)
61,0 (18,0)
60,7 (16,4)
69,9 (13,5)
69,3 (17,8)
69,6 (15,8)
73,6 (13,2)
78,7 (9,6)
76,7 (11,3)
79,5 (9,8)
83,9 (9,4)
82,0 (9,7)
Nota: norma de prueba EOWPVT:METRO=100; SD = 15. Normas de prueba TACL y CELF-WS:METRO=10; SD = 3. Los números en negrita son medias y SD de toda la muestra en cada medida de lenguaje, así
como el porcentaje de toda la muestra con una puntuación igual o superior a 1 SD de la media normativa de la prueba. El porcentaje se puede comparar con el 85 % de la muestra normalizadora de
audición que puntuó en este nivel. A todos los niños se les administró la prueba de vocabulario y sintaxis receptiva en inglés. Solo a los niños bimodales y de solo señas se les administró la prueba de
sintaxis receptiva de ASL.
Tabla 4Medias y desviaciones estándar por tiempo, grado y grupo en puntajes estándar de medidas de lectura
Prueba Puntaje Grupo Jardín de infancia
Caer Primavera
METRO(DAKOTA DEL SUR) METRO(DAKOTA DEL SUR)
Primer grado
Caer Primavera
METRO(DAKOTA DEL SUR) METRO(DAKOTA DEL SUR)
Segundo grado
Caer Primavera
METRO(DAKOTA DEL SUR) METRO(DAKOTA DEL SUR)
Total %≥85
METRO(DAKOTA DEL SUR)
Una sola palabra
(ID de palabra WJ)
Estándar
puntaje
Hablado 95,6 (16,5) 101.2
(14.1)
96,2 (15,1) 98,3 (14,3) 91,6 (14,3) 90,3 (13,1) 90,3 (15,9) 88,1 (16,3) 92,9 (15,0)
91,7 (14,4) 91,6 (13,8) 86,0 (14,1) 86,4 (14,4) 80,2 (15,8) 78,6 (16,7) 85,9 (15,6)
94,5 (15,4) 97,1 (14,6) 90,8 (14,9) 90,7 (14,5) 85,5 (15,4) 84,3 (15,7)91,2 (15,7)
76%81%66%69%49%53%67%
103.7
(15.2)
97,8 (20,5) 95,0 (17,6) 80,3 (16,1) 81,3 (15,5) 79,6 (20,7) 77,4 (21,1) 85,6 (19,9)
81,4 (14,1) 73,6 (12,7) 66,1 (12,9) 62,7 (14,8) 62,2 (18,6) 55,6 (21,2) 66,0 (17,6)
96,6 (18,8) 90,4 (19,3) 78,8 (19,0) 78,0 (20,0) 74,7 (21,5) 71,2 (24,3)82,2 (22,2)
67%60%34%36%36%37%46%
97,0 (12,8) 96,6 (15,7) 86,4 (15,5) 85,4 (12,0) 81,6 (8,3)
96,6 (13,0) 94,0 (16,6) 84,5 (14,2) 80,9 (14,3) 79,0 (15,9)
95,1 (12,3) 89,3 (14,2) 79,6 (17,0) 75,9 (14,9) 71,9 (13,0) 68,6 (16,4) 80,4 (17,3)
96,3 (12,6) 93,3 (15,7) 83,0 (15,9) 80,1 (14,4) 76,4 (13,5) 74,4 (15,1)85,2 (16,7)
86%75%47%36%29%25%53%
97,4 (14,5) 98,1 (13,9) 89,6 (11,0) 89,7 (9,0) 96,1 (14,4) 81%
bimodal
Firmar
Total
%≥85
Hablado
72%
53%
Sin palabras (WJ
Ataque de Palabra)
Estándar
puntaje
102.7
(14.0)
97,4 (14,3) 96,6 (13,4) 91,3 (11,7) 91,7 (11,2) 98,7 (14,4) 83%
bimodal
Firmar
Total
%≥85
Hablado
bimodal
Firmar
Total
%≥85
49%
13%
Lectura comp.
(Paso WJ.
Comp.)
Estándar
puntaje
81,1 (8,3)
77,3 (14,7)
90,1 (14,5)
86,4 (16,4)
sesenta y cinco%
56%
43%
Nota. Normas de las subpruebas WJ:METRO=100; SD = 15. Los números en negrita son medias y SD de toda la muestra en cada medida de lectura, así como el porcentaje de toda la muestra con una
puntuación igual o superior a 1 SD de la media de la prueba normativa. El porcentaje se puede comparar con el 85 % de la muestra normalizadora de audición que puntuó en este nivel.
puntuaciones
alumnos de segundo grado (media = 73.0,gramo=1.01). Los niños que solo hablan
(media = 98,7) obtuvieron puntajes estándar más altos que los bimodales (media =
85.6,gramo=0.75) y niños de solo signos (media = 66.0,gramo=1.85). Los niños
bimodales obtuvieron puntajes estándar más altos que los niños de solo signos,
gramo=1.10. Las puntuaciones de los niños que solo usan señas disminuyeron de
68,0 a 64,2 a lo largo del año escolar,gramo=−0.44. La figura S2 muestra que los
niños que solo hablan hicieron aumentos constantes en las palabras sin palabras.
que primero calificadores (media = 78.4,gramo=0.73) y lectura a través del tiempo y el grado. Los niños bimodales lograron ganancias
menores. Los niños que solo usan señas progresaron más lentamente y sus
puntajes W disminuyeron en segundo grado.
Comprensión de lectura (comprensión de pasaje WJ)
La muestra total tuvo una puntuación media de 85,2 con el 53 % de los niños
puntuando dentro de 1 SD. Las puntuaciones disminuyeron de 86,5 a 83,8
Tabla 5Medias y desviaciones estándar por tiempo, grado y grupo en medidas de conciencia fonológica hablada
Prueba Puntaje Grupo Jardín de infancia
Caer Primavera
METRO(DAKOTA DEL SUR) METRO(DAKOTA DEL SUR)
Primer grado
Primavera
METRO(DAKOTA DEL SUR)
Segundo grado
Caer Primavera
METRO(DAKOTA DEL SUR) METRO(DAKOTA DEL SUR)
Total %≥7
Caer
METRO(DAKOTA DEL SUR) METRO(DAKOTA DEL SUR)
Sonido
fósforo
(CTOPP)
Estándar
puntaje
Hablado
bimodal
Firmar
Total
%≥7
Hablado
bimodal
Total
%≥7
7.8 (2.1)
7.2 (3.3)
4.3 (3.7)
6.4 (3.4)
67%
4.8 (4.9)
8.3 (2.1)
7.2 (3.3)
6.1 (3.1)
7.2 (3.0)
66%
9.4 (3.4)
7.4 (2.3)
6.3 (2.5)
4.5 (2.3)
5,8 (2,6)
32%
8.0 (4.0)
7.7 (2.9)
6.5 (2.2)
4.9 (2.1)
6.1 (2.6)
34%
9.4 (2.0)
6.3 (2.2)
6.4 (2.5)
5,0 (2,5)
5,7 (2,5)
38%
7,0 (3,3)
6,7 (0,6)
6.3 (2.4)
4,8 (2,6)
5.7 (2.4)
40%
7,9 (2,7)
7.7 (2.3)
6,7 (2,8)
4,9 (2,9)
6.3 (3.0)
50%
7.6 (4.1)
74%
54%
29%
Mezcla
(CTOPP)
Estándar 70%
puntaje 4.4 (4.5) 4.8 (5.2) 3.2 (4.0) 3.7 (4.2) 4.3 (4.0) 4.4 (3.6) 4.1 (4.3) 34%
4.6 (4.7)
42%
7.3 (4.9)
66%
5.3 (4.6)
44%
6.1 (4.4)
60%
5,5 (3,9)
46%
6,0 (3,6)
48%
5,8 (4,5)
52%
Nota. Normas de las subpruebas CTOPP:METRO=10; SD = 3. A todos los niños se les administró la prueba de coincidencia de sonido. Solo se les administró la prueba de blending a los niños bimodales y de
lenguaje hablado. Los números en negrita son las medias y las DE de la muestra completa en cada medida de conciencia fonológica hablada, así como el porcentaje de la muestra completa con una
puntuación igual o superior a 1 DE de la media de las medias de las pruebas normativas.
a lo largo del año escolar,gramo=0.19. Los niños de kindergarten (media =
94,8) obtuvieron puntajes más altos que los de primer grado (media = 81,6,
gramo=0,90) que puntuaron más alto que los de segundo grado (media =
75,4,gramo=0,42). Hijos que solo hablan (media = 90,1,gramo=0,59) y niños
bimodales (media = 86,4,gramo=0,39) puntuaron más alto que los niños de
solo signos (media = 80,4), sin diferencias entre los dos primeros grupos. Los
niños que solo usan señas disminuyeron sus puntuaciones desde el otoño
(media = 82,4) hasta la primavera (media = 78,3,gramo=0,33) al igual que los
niños bimodales (media de otoño = 87,8; media de primavera = 85,0,gramo=
0,21). Por el contrario, las puntuaciones de los niños que solo hablan se
mantuvieron estables durante el año escolar (media de otoño = 90,4, media
de primavera = 89,8;gramo=0,02). La Figura S2 muestra que, si bien los tres
grupos aumentaron sus puntajes W de comprensión de lectura con el
tiempo, la brecha entre sus puntajes y los de la muestra normativa aumentó
con el grado.
Coincidencia de sonido (coincidencia de sonido CTOPP)
un puntaje promedio de 6.3 con el 50% de los niños obteniendo puntajes dentro o
por encima del rango promedio. Los niños que solo hablan por señas (media = 4.9)
obtuvieron puntajes más bajos que los que solo hablan (media = 7.7,gramo=0,88) y
niños bimodales (media = 6,7,gramo=0,60), sin diferencia entre estos dos últimos
grupos.
La muestra total tuvo
Mezcla de sonido (mezcla CTOPP)
Los niños DHH tuvieron un puntaje promedio de 5.8 con el 52% de los niños
obteniendo puntajes dentro del rango promedio. Las puntuaciones aumentaron
desde el otoño (media = 5,1) hasta la primavera (media = 6,6),gramo=0.31. Hijos
que solo hablan (media = 7.6,gramo=0,86) obtuvieron puntuaciones más altas que
los niños bimodales (media = 4,1) y aumentaron sus puntuaciones desde el otoño
(media = 6,2) hasta la primavera (media = 9,0),gramo=0,53. La Figura S3 muestra
que ambos grupos aumentaron sus puntajes combinados desde el otoño hasta la
primavera, pero la brecha entre sus puntajes y los del grupo de normalización
auditiva aumentó con el grado.
Bimodal y solo hablado
Resumen de resultados de lectura
Si bien la mayoría de los niños DHH de kínder obtuvieron puntajes dentro del rango
promedio en las tres habilidades de lectura evaluadas, los puntajes estándar disminuyeron
con el grado, con tamaños de efecto grandes. Las habilidades de lectura de los niños de
kínder fueron similares a las de la muestra normalizada, con un 75 % con puntajes de
comprensión de lectura de primavera dentro del rango promedio. Por el contrario, solo el
25% de los alumnos de segundo grado obtuvieron calificaciones dentro del rango
promedio en la primavera. Los tres grupos diferían ampliamente en las habilidades de
lectura. Los niños en el grupo de solo señas obtuvieron puntajes más bajos que los niños
en los grupos bimodales y solo hablados en las tres pruebas de lectura, con tamaños de
efecto medianos a grandes. Los niños bimodales y de lenguaje hablado diferían en la
lectura de no palabras, pero no en la lectura de una sola palabra o la comprensión de
lectura. Para la primavera de segundo grado, los niños de los tres grupos tenían mejores
habilidades de lectura de palabras que de comprensión de lectura. Para el segundo grado,
aunque los puntajes disminuyeron con el grado, los niños bimodales y solo hablados
todavía tenían habilidades de lectura de palabras cercanas a las apropiadas para su edad,
mientras que los niños que solo usaban señas obtuvieron 1 SD por debajo de los
promedios normativos. Los tres grupos obtuvieron calificaciones por debajo de las normas
auditivas en comprensión de lectura.
Spoken PA results summary
dren had spoken phonological awareness skills within the average
range and performed equally well on sound matching and blending.
Bimodal children performed much better on sound matching than
sound blending. Sign-only children scored more than 1.5 SD below the
test norms on sound matching.
The majority of spoken-only chil-
Fingerspelling PA
Table 6 displays percentage of items correct for the sign-only and
bimodal children. Tables S11–S13 display model results.
FS imitation
over the school year, g = 0.58. Kindergarteners had lower scores (mean
= 22.3%) than first graders (mean = 39.0%), g = 0.79, who had lower
scores than second graders, (mean = 61.2%), g = 1.03. Figure S4 shows
the steady increase in percentage correct items for sign-only and
bimodal children with time.
Children increased their scores from 34.0 to 45.3%
Spoken Phonological Awareness (PA) FS blending
over the school year, g = 0.50. Kindergarteners (mean = 9.0%) scored
lower than first graders (mean = 20.0%, g = 0.60) who scored lower
than second graders (mean = 37.4%, g = 0.97).
Children increased their scores from 17.0 to 26.7%,
Table 5 displays spoken PA standard score means, SDs, and the
percentage of the sample scoring within the average range or higher.
Tables S8–S10 display model results.
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Table 6 Means and standard deviations by time, grade, and group on fingerspelling phonological measures
Test Score Group Kindergarten
Fall Spring
M (SD) M (SD)
First grade
Spring
M (SD)
Second grade
Fall Spring
M (SD) M (SD)
Total
Fall
M (SD) M (SD)
F.
Imitation
Percent
correct
Bimodal
Sign
Total
Bimodal
15.8 (17.6) 28.8 (22.9) 28.9 (22.0) 41.6 (21.0) 54.4 (23.1) 73.4 (16.5) 37.7 (27.3)
40.9 (26.8)
39.5 (27.0)
19.5 (21.4)
22.6 (25.1)
21.3 (23.6)
14.9 (24.7)
16.2 (25.1)
15.6 (24.9)
17.1 (16.4)
16.5 (16.9)
6.3 (13.0)
3.5 (7.7)
4.7 (10.5)
2.4 (11.4)
4.4 (13.3)
3.5 (12.4)
27.4 (21.2)
28.0 (21.9)
36.3 (24.9)
32.9 (23.8)
49.7 (25.1)
45.8 (23.4)
56.8 (20.8)
55.9 (21.6)
62.6 (20.8)
67.0 (19.7)
F.
Blending
Percent
correct
14.0 (19.5)
11.9 (19.2)
16.8 (18.7)
16.2 (19.5)
18.0 (17.9)
28.1 (27.6)
27.0 (21.6)
35.5 (24.7)
43.2 (21.7)
Sign 43.6 (23.2)
Total
Bimodal
Sign
Total
12.8 (19.2) 16.5 (19.0) 23.4 (23.9) 32.1 (23.7) 43.4 (22.4)
- Elision Percent
correct
7.0 (14.2)
4.9 (11.8)
5.8 (12.9)
4.3 (8.2)
8.5 (15.6)
6.5 (12.8)
18.0 (22.9)
20.1 (26.3)
25.0 (28.5)
25.4 (27.5)
41.7 (35.1)
37.1 (32.9)
19.1 (24.6) 25.2 (27.7) 39.0 (33.6)
Note. All means are percentage of correct items. The bold numbers are means and SDs of the whole sample on each fingerspelling phonological measure.
Figure S4 shows the steady increase of percentage correct items for
both groups with time.
to spoken language made gains in expressive English syntax, though
they scored well below age norms. Those students who had access to
sign made steady gains in ASL syntax.
Our sample achieved an average expressive vocabulary standard
score of 83, lower than the standard score of 91 reported by Geers et
- (2009), but similar to the average score of 81 achieved by children 8
years of age as reported by Hayes et al. (2009). Less than 50% of the
children scored within the average range (standard scores 85–115)
somewhat worse than the 58% reported by Geers et al. Children in all
three grades made progress during the course of the school year, but
kindergartners and first graders made greater than expected progress
(based on test norms), while second graders made expected progress.
Our sample showed better outcomes than that of Connor et al. (2000)
who reported that, although vocabulary growth was positive, growth
was less than expected based on test norms. In first and second
grades, our total sample showed annual gains of 3–5 standard score
points, which was substantial, but less than the 8 standard scores in
annual gain reported by Hayes et al. (2009). It is important to note that
children did not differ on vocabulary knowledge based on their group.
Despite greater than expected progress during the school year, the
gap between the DHH students and their typical hearing peers
remained wide across grades. This suggests that elementary-aged
DHH children may be losing the gains they made during the school
year over the summer as has been shown for preschoolers (Scott,
Goldberg, Connor & Lederberg, 2019).
English syntax was the weakest area for all children as reported
also by other researchers (Geers et al., 2003; Hay-McCutcheon et al.,
2008). The children in our sample were 1.5 SD below age norms in
receptive English syntax and 2.5 SD below in expressive English syntax.
Access to spoken language (in this case spoken English) was an
advantage in learning receptive English syntax, ref lected in the similar
and higher scores of spoken-only and bimodal children compared to
the sign-only children. However, all three groups showed some
improvement (shown by raw scores) in receptive English syntax over
the school year. While progress might be expected of the children who
had auditory access to English, the sign-only children without such
access also mastered additional items. We speculate that these
children may be developing bilingual skills and learning to understand
English word order from adults around them who use contact sign.
Consistent with findings by other researchers (e.g., Geers et al.,
2003, 2009), access to spoken language was not sufficient
FS elision
19.9% over the school year, gramo=0.56. Kindergarteners did not
increase their scores. First graders increased their scores from 6.5 to
19.1%, gramo=0.72. Second graders increased their scores from 25.2 to
39.0%, gramo=0.80. Kindergarteners scored lower (mean = 4.7%) than
second graders (mean = 31.9%), gramo=1.49, but not first graders. First
graders (mean = 12.8%) scored lower than second graders, gramo=
1.05. As is evident in Figure S4, while most kindergarteners could not
do this task, there was a steady increase in percentage correct
responses from first grade fall through second grade spring.
Children increased their scores from 11.3 to
FS summary Both sign-only and bimodal children made similar and
steady gains on these three tasks. Imitation was the easiest task, while
elision was the hardest. By second grade, children did not reach ceiling
for any of the fingerspelling tests.
Discussion
The purpose of this research was to describe the language and literacy
of a large sample of young DHH children and examine their progress
longitudinally over the course of a school year, cross-sectionally from
grade to grade, as well as across groups. We purposefully included
DHH students who had different access to language; thus we included
children who had access to spoken or sign language only and also
those who had access to both. The latter group particularly tends to be
little studied. We discuss key findings arranged by the major
constructs: language, reading, and spoken and fingerspelled
phonological awareness.
Idioma
While children started in kindergarten delayed compared to the
hearing test norms, they made greater than expected gains during the
school year, as shown by increases in standard scores in all areas of
language from fall to spring. Substantially more children achieved
within the average range in vocabulary than in English syntax. In
vocabulary and English syntax, children made expected progress
between kindergarten and second grade, compared to age-based
hearing norms. Children who had access
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for acquiring age-appropriate expressive English syntax. Only 11% of
children in the spoken-only and bimodal groups scored within the
average range on the CELF. However, the spoken-only children made
more than expected progress from fall to spring, while the bimodal
children made expected progress. The raw scores show that the
spoken-only children mastered about five additional items during the
school year; the bimodal children mastered less than one additional
item. These differences may ref lect a different instructional focus
across classrooms; teachers may spend more time in direct or indirect
instruction on English syntax in spoken-language-only classrooms.
Both groups of children who had access to sign (bimodal and signonly)
showed substantial improvement in ASL receptive syntax from fall
to spring and from grade to grade. In fact, by the end of second grade,
children were close to ceiling on this assessment. There was no effect
of group, suggesting that access to spoken language did not appear to
inhibit the bimodal children’s learning of ASL syntactical structures.
that their W scores increased over time suggests they may use visual
and kinesthetic means to acquire knowledge of spoken phonemes (
Haptonstall-Nykaza & Schick, 2007;Kyle, Campbell & MacSweeney, 2016
;Kyle & Harris, 2010). Sign-only children also showed lower
achievement in word reading and reading comprehension compared
to both bimodal and spoken-only children. Given that the three groups
did not differ in overall language ability (Lederberg et al., 2019), and
that bimodal and sign-only children were exposed to the same sign
input in the classroom, it appears that access to spoken language
facilitated learning to read. Sign-only children need to learn to
translate English words into ASL which is a complex process (
Hoffmeister y Caldwell-Harris, 2014).
Phonological Awareness
As expected, auditory perception was an advantage for spoken
phonological awareness. Spoken-only children scored within the low
average range on both sound matching and blending. These results
are similar to those reported by James et al. (2008) for early implanted
CI children and what some researchers have found for DHH
kindergarteners (Kyle y Harris, 2011; Nittrouer et al., 2012). The
bimodal children were similar to the spoken-only children on sound
matching but scored considerably lower in sound blending. Their
poorer performance on blending might have been due to speech
production issues. Although the sign-only children received standard
scores about 3 SD below the test norms on sound matching, the raw
scores for this group at each grade level were greater than 0 and
increased from fall to spring. As with nonword reading, these results
might indicate that sign-only children are using visual information such
as speechreading and fingerspelling to identify some spoken
phonemes.
This is the first study to examine developmental change in
fingerspelling PA. Fingerspelling increased across the school year and
grade to grade. Imitation was a relatively easy task while elision was
difficult. The ability to manipulate the sublexical features of words, as
shown in the blending and elision tasks, increased across time, but
even second graders were correct on less than half of the items. This is
worse than the spoken-only children did on the parallel task of sound
blending. It may be that blending fingerspelling is a more difficult task,
but it also may be a result of lack of instruction on this skill in signing
classrooms. Both the sign-only and bimodal children performed in a
remarkably similar manner on the fingerspelling tasks achieving
similar percentage scores and showing significant growth from fall to
spring and developmental differences across grades. This may suggest
the bimodal children could access the sublexical features of English
words through both auditory and visual means, and access to one did
not seem to inhibit learning in the other.
Lectura
Reading, to a much larger extent than language, was affected by both
grade and group. Kindergarteners showed age-appropriate skills in all
three areas assessed: single-word reading, nonword reading, and
reading comprehension. At kindergarten, these tests assess children’s
emerging literacy skills, namely, alphabetic knowledge (letter-name,
letter-sound) and the ability to understand concepts depicted by
rebuses (not printed words). Other researchers (e.g., Cupples et al.,
2013) have also reported that hearing loss and language delay does
not prevent acquisition of these early skills. The children in our sample
increased their reading skills from fall to spring and from grade to
grade as indicated by their W scores but made less than expected
progress from kindergarten to second grade, consistent with findings
of other researchers (Harris et al., 2017b;Kyle y Harris, 2011).
Group had a large effect on reading. Spoken-only children had ageappropriate
nonword and single-word reading skills with 80% of
children (across grades) scoring in the average range, very close to the
85% for the normative sample. Thus, spoken-only children were able to
develop the knowledge of how to sound out and blend fairly complex
words by second grade. Lederberg et al. (2013) suggest that phonics
instruction may be particularly effective with DHH children who have
auditory access to spoken language because letters can serve as visual
support for their learning of spoken phonology. Despite strength in
word reading, spoken-only children showed a decline of 16 standard
points in reading comprehension from kindergarten to second grade.
Bimodal children had weaker nonword reading skills than spokenonly
children, with 50% scoring within the normative average range.
Despite differences in phonological and spoken language skills,
bimodal and spoken-only children had similar word reading and
reading comprehension achievement. These results are in contrast to
researchers that report differences favoring children using spoken
language (Dillon & Pisoni, 2006) but similar to Geers (2003)) who found
no effect of communication modality on reading skills for children with
CIs.
Sign-only children were delayed in all three reading skills and
showed greater delays than spoken and bimodal children. These
children’s difficulty with nonword reading would be expected given
their lack of access to spoken language. The fact
Assessment Issues
Every researcher is faced with the issue of how to effectively and
ethically assess DHH children on tests that are not specifically designed
or normed for them. We chose to administer mostly standardized tests
of language and reading that were well validated and widely used with
hearing children because these provided us with interpretable data to
examine growth over a school year and across grades. We purposefully
did not administer every test to each child but assessed children on the
tests that had items that were accessible to them and that they had the
opportunity to acquire based on their language
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and communication environment. We judged it unethical to take time
away from classroom instruction for assessments that were clearly
invalid for specific groups of children. Thus, we did not assess the signonly
children on the spoken phonological awareness blending subtest
because it required spoken responses. We assessed bimodal children
on phonological awareness, because the ESP data indicated that they
had auditory access to spoken English even if they were in a signing
educational environment. We did not assess spoken-only children on
ASL receptive syntax or fingerspelled phonological awareness, because
they were not exposed to and therefore could not acquire sign or
fingerspelling.
Modifying standardized tests raises questions about whether
standardized scores and test norms are appropriate to use. On the
other hand, administering standardized tests in one invariant manner
to all DHH children raises questions about assessment validity. We
believe that making some reasonable modifications to allow the range
of DHH children access to the test items and ensuring that these
modifications were consistently used ensured, as much as possible,
that the test scores we obtained were valid (Sechrest, 2005). In order to
ensure that assessments were valid for each group of children, we
made standard adaptions to each test to accommodate the different
language and communication access and environments, but we
ensured that these adaptations were not idiosyncratic or dependent on
the skill of individual examiners. We ensured that all examiners were
trained to administer each test and took extreme care with scoring.
Despite the variability in children’s language and communication
access, we obtained high interrater reliability for all tests for all groups.
Despite these precautions, it is possible that some assessment results,
such as spoken phonological blending, were inf luenced by children’s
expressive speech capabilities. However, we tested many of these
validity questions for the fall time point (Lederberg et al., 2019) and
found that the tests had good psychometric properties for their
intended constructs and had no strong evidence of bias across groups.
standing both the specific language skills and the level of proficiency of
these skills necessary to improve outcomes.
Implications for Instruction
The documentation of language and reading status and progress
indicates some areas in which we can focus instructional practice. In
the area of language, although vocabulary is a relative strength, the
majority of children have lexicons that are considerably smaller than
their typical hearing peers. English syntax is a notable weakness even
for children with access to spoken language. Systematic and intensive
instruction in each of these areas is probably beneficial for all children.
On the other hand, children with access to sign in the classroom
appear to be making progress in ASL syntax, indicating that, when the
structure of language is visual and therefore completely accessible,
current instructional practices may be sufficient to ensure acquisition.
Classroom instruction and teacher talk can make a difference in
children’s language learning. Duncan and Lederberg (2018) examined
teacher talk in classrooms and reported that explicit vocabulary
instruction and teachers’ reformulation of children’s utterances were
predictors of gains in children’s vocabulary and expressive English
syntax. These authors also reported that teachers were highly variable
in the amount of explicit vocabulary instruction in which they engaged
and that explicit morphosyntax instruction occurred rarely. Given DHH
children’s delays in vocabulary and English morpho-syntax, it might be
necessary for teachers to engage in explicit direct instruction and for
researchers and practitioners to collaborate on developing and
evaluating instructional practices in these areas.
In the area of reading, all children acquired the simple skills, such
as letter naming and matching rebuses to pictures that are required at
the kindergarten level, but had difficulty with word reading and
comprehension that are required by the second grade. According to
the SVR, reading comprehension requires both f luent decoding and
linguistic comprehension (Gough & Tunmer, 1986;Tunmer & Chapman,
2012). The challenge, as always, is identifying the kind of instruction
that will help DHH students make sufficient progress in both these
areas. Ongoing research by the authors documenting reading
instruction in classrooms should assist in identifying the interaction
between instruction and children’s progress in reading. Such
knowledge should help determine effective teaching strategies and the
amount of time children need to be engaged in different types of
reading instruction.
Implications for further research
study was that the bimodal children in our sample, a group seldom
studied, are learning both English and ASL and making progress in
both languages. However, this finding needs to be replicated with
other samples of bimodal children. We need to also address how
development, and perhaps instruction, in both languages inf luences
reading development. For example, it would be informative to study
exactly how bimodal children use spoken and sign language while
reading. It would also be informative to study whether exposure to
English-like sign facilitates reading. Another area that needs further
study is the inf luence of fingerspelling on reading decoding for DHH
children. Our previous research showed that reading was strongly
related to fingerspelling (Lederberg et al., 2019) and there is some
evidence that signing DHH children benefit from connecting
fingerspelled words to print (Haptonstall-Nykaza & Schick, 2007).
However, evidence is needed on the role of systematic instruction in
this area.
We also need to explore further why children made comparatively
little progress in reading comprehension. Even spokenonly children
who showed close to age-appropriate language on word reading and
nonword reading showed delays in reading comprehension by the end
of second grade. One explanation might be that our sample displayed
weak English syntax skills; the SVR suggests that both decoding and
language are equally important to comprehension. Detailed analyses
of reading comprehension profiles (Kyle & Cain, 2015) hold promise for
under-
An important finding of this
Limitations
A limitation of this study is that we did not include a comparison group
of typically hearing children and thus were only able to compare the
DHH children’s scores to published test norms. Because our sample is
also not matched to the test sample, a comparison group matched on
variables such as socioeconomic status or ethnicity would have
provided more precise information on overlap, progress, and specific
areas of delay in language and reading. Technically, standard scores
are also not on a longitudinally consistent metric. However, the effects
of standardization are likely to be small for the current shortterm
longitudinal design. Our sample also does not represent the larger
population of DHH children; rather, we focused on children in selfcontained
programs. These children are likely to be those most in need
of intensive instruction, but our results should not be generalized to all
DHH children. Another limitation is that we only received self-reports
from teachers about
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their use of ASL or signed English. We were not able to obtain
observational or other data to confirm the kind of signing occurring in
classrooms.
Although we examined differences due to time, grade, and group
on several outcomes, there are many other malleable variables that inf
luence individual children’s language and reading. Other researchers,
for example, have documented the effects of age of implantation, age
of diagnosis and intervention, and the quality of early intervention (
Dunn et al., 2013;Geers et al., 2009;Kyle & Harris, 2010;Moeller, 2000).
For any single child, variables impacting language and reading will also
include those related to the home (e.g., parental access to professional
support, home literacy environments) and to school (e.g., quality and
consistency of classroom instruction). Given the low incidence of
childhood deafness, and the difficulty of examining large samples, it is
likely that no single study can examine simultaneously all possible
variables. It is important that readers keep in mind that the variables
examined in this study are only some of the many variables that will
impact children’s language and reading.
Unlike some researchers, we included children whom teachers
reported as having mild disabilities. Because it is possible that the
presence of these disabilities may have inf luenced the results, we ran
post hoc analyses to examine the effects of disability. Children with
mild disabilities scored, on average, lower than children without
disabilities. While there were main effects, disability status did not
interact with time, grade, or group. Excluding children with mild
disabilities changed minimally the overall means and analyses reported
in this paper.
Conclusion
The positive news is that the DHH children in our sample made
progress in vocabulary learning and were acquiring the syntax of either
English (spoken-only and bimodal children) or ASL (sign-only and
bimodal children). Thus, despite delays, children were acquiring
language to which they had access in their environment. They were
also developing phonological processing skills either auditorily or
visually. However, for all groups, delays in reading comprehension
increased in higher grades. Future research might clarify how and why
classroom instruction inf luences these outcomes. The challenge, as
always, will be to develop evidence-based instructional strategies that
will lead to improvement in literacy for all children while taking
advantage of their opportunities for visual and auditory access to
language.