Linguistic and behavioral performance of bilingual children with hearing loss

Objective: To compare the English and non-English language performance of deaf or hard-of-hearing (DHH) children raised in homes where English was not the primary language to their typically hearing peers from similar language backgrounds. Methods: Case control study of bilingual DHH children with unilateral or bilateral non-fluctuating hearing loss defined as the most recent PTA between 26 and 70 dB in one or both ears. Typically hearing controls included bilingual siblings and children recruited from the General Pediatrics practice. Subjects completed the OWLS-II, a validated English language proficiency tool. The subject's parents completed the Child Behavioral Checklist, an assessment of problem behavior; the Student Oral Language Observation Matrix (SOLOM), an assessment of the child's non-English home language; and a study questionnaire on the child's medical, social, and language history. Results: 26 typically hearing controls, 15 children with bilateral hearing loss, and 18 children with unilateral hearing loss participated. The groups were similar in age, sex, insurance status, place of birth, age at arrival in the US, and maternal education status. Performance on the English language oral composite was significantly lower amongst the bilateral hearing loss group (BHL: 66.9, 95% CI [56.2-77.7]; UHL: 82.9, 95% CI [75.6-90.2]; NH: 84.4, 95% CI [79.5-89.3], p = 0.002). Performance on the SOLOM was significantly lower in bilateral hearing loss group. (BHL: 18.6, 95% CI [15.9-21.3]; UHL: 19.8, 95% CI [17.1-22.4]; NH: 22.3, 95% CI [20.6-24.0], p = 0.036). Conclusions: Bilingual children with bilateral hearing loss are at increased risk for poor oral expressive and receptive language development. These children comprise a particularly vulnerable population who might benefit from additional focused interventions to support their language development.