Spoken language processing in children who are DHH (Abrahamse et al., 2025)

Purpose: This study aimed to investigate how hearing loss affects (a) spoken language processing and (b) processing of faster speech in school-age children who are deaf and hard of hearing (DHH).

Method: Spoken language processing was compared in thirty-six 7- to 12-year-olds who are DHH and 31 peers with normal hearing using a word detection task. Children listened for a target word in sentences presented at a normal (4.5 syllables per second [syll./s]) versus fast (6.1 syll./s) speaking rate and pressed a key when they heard the word in the sentence. Response time was taken as an outcome measure. Relationships between working memory capacity, vocabulary size, and processing speed were also assessed.

Results: Children who are DHH were slower than their peers with normal hearing to detect words in sentences, but no evidence for a negative effect of speaking rate was observed. Furthermore, contrary to expectation, a larger working memory capacity was associated with slower spoken language processing, with effects stronger for younger children with smaller vocabulary sizes.

Conclusions: Regardless of speaking rate, children who are DHH may be at risk for delays in spoken language processing relative to peers with normal hearing. These delays may have consequences for their access to learning and communication in spoken forms in everyday environments, which contain additional challenges such as background noise, competing talkers, and speaker variability.

Supplemental Material S1. Target words and sentences of the Auditory Word Detection task for each list.

Supplemental Material S2. Description of speaking rate stimuli.

Supplemental Material S3. The percentage of anticipatory presses per sentence structure (n = 254).

Supplemental Material S4. Correlations between predictors and model outcomes.

Supplemental Material S5. RT transformations.

Supplemental Material S6. (A) Results of the maximal confirmatory model with Age as an interacting predictor, showing model estimates, standard errors (SE), t-values and p-values (p). (B) Results of a simpler confirmatory model with Age as a non-interacting predictor, showing model estimates, standard errors (SE), t-values and p-values (p).

Supplemental Material S7: Model syntax of the final parsimonious model (constructed using R lme4 package).

Supplemental Material S8. Results of the exploratory model with Age as an interacting predictor (showing that Age does not significantly interact with variables of interest Hearing Characteristics or Rate).

Supplemental Material S9. Visualisation of the interaction between the Age * WM * PPVT ~ RT predictors (of the final parsimonious model).

Abrahamse, R., Benders, T., Demuth, K., & Rattanasone, N. X. (2025). Investigating the effects of speaking rate on spoken language processing in children who are deaf and hard of hearing. Journal of Speech, Language, and Hearing Research. Advance online publication. https://doi.org/10.1044/2025_JSLHR-24-00108