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INFLUENCES OF HEARING IMPAIRMENT ON
EARLY LANGUAGE DEVELOPMENT
RITA
C.
NAREMoRE,
PhD
BLOOMINGTON,
INDIANA
It
is difficult to determine exactly the effects of chronic otitis media on early language de-
velopment, in
part
because we do not know whether hearing loss resulting from otitis media is
intermittent or constant,
and
in
part
because it is difficult to assess the precise language ability
of very young children. This
paper
focuses on those aspects of language development which
one might expect hearing impairment to affect,
and
presents several hypotheses
about
the pos-
sible effects of mild-to-moderate hearing loss on the earliest stages of language development.
It
is difficult to make any set of con-
clusive statements about the early lan-
guage development of hearing-impaired
children. Most of the available research
into the relationship between hearing
loss and language development involves
school-age children, or children who are
enrolled in some kind of special training
program. Information about what these
children do in that crucial language-
learning period between birth
and
36
months is sadly lacking. One reason for
this, of course, is that mild-to-moderate
hearing loss may be extremely difficult
to detect in this age range. Parents are
unlikelv to ask for a hearing test unless
something in the child's behavior causes
them to suspect that the child does not
hear,
and
whether it is because parents
don't recognize the signs of hearing loss
or because there are no readily identi-
fiable signs, many children with hearing
loss go undetected. The consequences
of hearing loss in these early years can
sometimes be striking. Roughly
60%
of
the children who come through our clin-
ic with language problems, many
labeled "learning disabled," have some
degree of hearing loss, and most of these
have histories of chronic otitis media.
In most instances, of course, we cannot
determine the age of onset of the hear-
ing loss, nor are we able to say whether
it has been constant or intermittent. The
constellation of symptoms, however, is
too frequent to ignore. More informa-
tion about early language development
in hearing-impaired children is needed,
not onlv to help us predict the later pro-
gress of such children,
but
also to illumi-
nate the role played by specific levels of
auditory input in young children's com-
prehension and production of language.
This
paper
will focus on the possible
implications of hearing loss in terms of
the prerequisites for language learning
in young children. A final section will
deal with the difficulties of assessing
language development in children in
this age range.
PREREQUISITES FOR LANGUAGE
LEARNING
Because we all use language so read-
ily as a means of communicating, we
tend to take it for granted,
and
to be un-
aware of the complexity of the behavior.
What
does it mean to be able to learn
alanguage
and
use it in everyday com-
munication? To learn a language, one
must segment the stream of sounds, as-
sign meaning to the segments, and un-
derstand the rules governing the com-
bination of segments into novel utteran-
ces. This does not sound like a terribly
difficult task for an adult who already
knows a language,
and
who can ap-
proach the language-learning task in
terms of what one already perceives
about language structure. Adults know
that things have names, and
that
words
are combined to make sentences. They
know about noun plurals and verb
tenses. One difference between the
adult's situation and that of the young
child would be that children learning a
first language obviously cannot be guid-
ed in this attempt by prior knowledge
of language structure.
What
then, does
From
the
Speech
and
Hearing
Center,
Indiana
University,
Bloomington,
Indiana.
54
