Overall, the findings suggest that the poorer performance of older adults in the AV condition was a result of reduced speechreading abilities rather than a consequence of impaired integration capacities. The pattern of correlations across the three stimulus types indicates some overlap in the mechanisms mediating AV perception of words and sentences and that these mechanisms are largely independent from those used for AV perception of consonants.

Objective To determine whether elementary school-aged children with unilateral hearing loss (UHL) demonstrate significantly worse language skills than their sibling controls with normal hearing, and whether they are more likely to receive extra assistance or resources at school. Patients and Methods Case-control study of age 6-12 year old children with UHL compared with sibling controls (74 matched pairs, total n=148), all with normal cognition by parental report. Scores on the oral portion of the Oral and Written Language Scales (OWLS) were the primary outcome measure. Potential confounders were evaluated for their effect on the OWLS scores. Multivariable analysis was used to determine whether UHL independently predicted OWLS scores. Results Children with UHL had significantly worse language comprehension (91 vs. 98, P = 0.003), oral expression (94 vs. 101, P = 0.007), and oral composite (90 vs. 99, P <0.001) scores than their siblings with normal hearing. Multivariable regression models demonstrated that UHL was an independent predictor of these OWLS scores, with moderate effect sizes of 0.3 to 0.7. Family income and maternal education level were also independent predictors of oral expression and oral composite scores. No differences were found between children with right or left UHL, nor with varying severity of hearing loss. Children with UHL were more likely to have an Individualized Education Plan (OR 4.4, 95% CI 2.0-9.5) and to have received speech-language therapy (OR 2.6, 95% CI 1.3-5.4). Conclusions School-aged children with UHL demonstrated worse oral language scores compared with siblings with normal hearing. These findings suggest that the common practice of withholding hearing-related accommodations from children with UHL should be reconsidered and studied, and that parents, pediatricians, and educators be informed about the deleterious effects of UHL on oral language skills.

Objective Children with unilateral hearing loss (UHL) have been found to have lower language scores, and increased rate of speech therapy, grade failures, or needing Individualized Education Plans (IEPs). The objective of this study was to determine whether language skills and educational performance improved or worsened over time in a cohort of children with UHL. Study Design Prospective longitudinal cohort study Methods Forty-six children with permanent UHL, ages 6 to 12 years, were studied using standardized cognitive, achievement, and language testing at yearly intervals for three years. Using standardized test scores allowed implicit comparison to norms established by national cross-sectional samples. Secondary outcomes included behavioral issues, IEPs, receipt of speech therapy, or teacher report of problems at school. Analysis utilized repeated measures ANOVA and multilevel random regression modeling. Results Several cognitive and language mean standardized scores increased over time. Possible predictors of increase with time included higher baseline cognitive levels and receipt of interventions through an IEP. However, standardized achievement scores and indicators of school performance did not show concomitant improvements. Rates of IEPs remained > 50% throughout, and rates of speech therapy were consistently about 20%. Conclusions Children with UHL demonstrated improvement in oral language and verbal IQ scores over time, but not improvements in school performance. Parents and teachers reported persistent behavioral problems and academic weaknesses or areas of concern in about 25%. The provision of IEPs for children with UHL, and acknowledging UHL as a hearing disability, may be an effective intervention to improve language skills over time.

Overall, the results of the current study suggest that despite increased reliance on visual speech information, older adults who have hearing impairment do not exhibit better V speech perception or auditory-visual integration than age-matched individuals who have normal hearing. These findings indicate that inclusion of V and AV speech perception measures can provide important information for designing maximally effective audiological rehabilitation strategies.