title: Language and speech outcomes of children with hearing loss and additional disabilities: identifying the variables that influence performance at five years of age.
abstract: This study examined language and speech outcomes in young children with hearing loss and additional disabilities.
  
  
  
  Receptive and expressive language skills and speech output accuracy were evaluated using direct assessment and caregiver report. Results were analysed first for the entire participant cohort, and then to compare results for children with hearing aids (HAs) versus cochlear implants (CIs).
  
  
  
  A population-based cohort of 146 five-year-old children with hearing loss and additional disabilities took part.
  
  
  
  Across all participants, multiple regressions showed that better language outcomes were associated with milder hearing loss, use of oral communication, higher levels of cognitive ability and maternal education, and earlier device fitting. Speech output accuracy was associated with use of oral communication only. Average outcomes were similar for children with HAs versus CIs, but their associations with demographic variables differed. For HA users, results resembled those for the whole cohort. For CI users, only use of oral communication and higher cognitive ability levels were significantly associated with better language outcomes.
  
  
  
  The results underscore the importance of early device fitting for children with additional disabilities. Strong conclusions cannot be drawn for CI users given the small number of participants with complete data.
authors.affiliation: a Department of Linguistics, Centre for Cognition and its Disorders , Macquarie University , Sydney , Australia.
authors.forename: Linda
authors.initials: L
authors.lastname: Cupples
authors.affiliation: b The Hearing CRC , Melbourne , Australia.|c National Acoustic Laboratories , Sydney , Australia , and.
authors.forename: Teresa Y C
authors.initials: TYC
authors.lastname: Ching
authors.affiliation: b The Hearing CRC , Melbourne , Australia.|c National Acoustic Laboratories , Sydney , Australia , and.
authors.forename: Laura
authors.initials: L
authors.lastname: Button
authors.affiliation: b The Hearing CRC , Melbourne , Australia.|d RIDBC Renwick Centre (Royal Institute for Deaf and Blind Children/The University of Newcastle) , Sydney , Australia.
authors.forename: Greg
authors.initials: G
authors.lastname: Leigh
authors.affiliation: b The Hearing CRC , Melbourne , Australia.|c National Acoustic Laboratories , Sydney , Australia , and.
authors.forename: Vivienne
authors.initials: V
authors.lastname: Marnane
authors.affiliation: b The Hearing CRC , Melbourne , Australia.|c National Acoustic Laboratories , Sydney , Australia , and.
authors.forename: Jessica
authors.initials: J
authors.lastname: Whitfield
authors.affiliation: b The Hearing CRC , Melbourne , Australia.|c National Acoustic Laboratories , Sydney , Australia , and.
authors.forename: Miriam
authors.initials: M
authors.lastname: Gunnourie
authors.affiliation: b The Hearing CRC , Melbourne , Australia.|c National Acoustic Laboratories , Sydney , Australia , and.
authors.forename: Louise
authors.initials: L
authors.lastname: Martin
mesh_terms: D000367:Age Factors; D001315:Australia; D002652:Child Behavior; D002663:Child Language; D002675:Child, Preschool; D003054:Cochlear Implants; D003071:Cognition; D019988:Children with Disabilities / Q000523:psychology* / Q000534:rehabilitation; D061345:Early Medical Intervention; D004522:Educational Status; D005260:Female; D006309:Hearing; D006310:Hearing Aids; D034381:Hearing Loss / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers / Q000523:psychology; D019986:Persons with Hearing Disabilities / Q000523:psychology* / Q000534:rehabilitation; D012720:Severity of Illness Index; D012813:Sign Language; D013060:Speech; D013997:Time Factors
keywords: Hearing aid; additional disabilities; children; cochlear implant; hearing loss; language outcomes