Impact of cognitive and linguistic ability on gaze behavior in children with hearing impairment

Abstract

In order to explore verbal–nonverbal integration, we investigated the influence of cognitive and linguistic ability on gaze behavior during spoken language conversation between children with mild-to-moderate hearing impairment (HI) and normal-hearing (NH) peers. Ten HI–NH and 10 NH-NH dyads performed a referential communication task requiring description of faces. During task performance, eye movements and speech were tracked. Cox proportional hazards regression was used to model associations between performance on cognitive and linguistic tasks and the probability of gaze to the conversational partner’s face. Analyses compare the listeners in each dyad (HI: n = 10, mean age = 12; 6 years, SD = 2; 0, mean better ear pure-tone average 33.0 dB HL, SD = 7.8; NH: n = 10, mean age = 13; 7 years, SD = 1; 11). Group differences in gaze behavior – with HI gazing more to the conversational partner than NH – remained significant despite adjustment for ability on receptive grammar, expressive vocabulary, and complex working memory. Adjustment for phonological short term memory, as measured by non-word repetition, removed group differences, revealing an interaction between group membership and non-word repetition ability. Stratified analysis showed a twofold increase of the probability of gaze-to-partner for HI with low phonological short term memory capacity, and a decreased probability for HI with high capacity, as compared to NH peers. The results revealed differences in gaze behavior attributable to performance on a phonological short term memory task. Participants with HI and low phonological short term memory capacity showed a doubled probability of gaze to the conversational partner, indicative of a visual bias. The results stress the need to look beyond the HI in diagnostics and intervention. Acknowledgment of the finding requires clinical assessment of children with HI to be supported by tasks tapping phonological processing.

Ten questions about terminology for children with unexplained language problems

“…A growing body of research points to co-occurrence of language impairment and other conditions. In our own research comparing children with mild to moderate sensorineural hearing impairment and children with language impairment (e.g., Sahlén and Hansson 2006 , Sandgren et al 2013 ) the findings are consistent with those of other authors (e.g., Briscoe et al 2001 , Gilbertson and Kamhi 1995 ). A considerable proportion of children with hearing impairment have similar problems as children with language impairment, but their problems are generally not as pervasive and persistent.…”

Working memory and referential communication—multimodal aspects of interaction between children with sensorineural hearing impairment and normal hearing peers

“…The group difference in gaze behavior remained significant despite adjustment for receptive grammar, expressive vocabulary, and complex WMC, but not non-word repetition, revealing an interaction between SNHI and PSTM capacity. Participants with SNHI with lower scores on non-word repetition (>1.25 SD below NH mean) showed a twofold increase in the probability of gaze to the speaker’s face, whereas those with higher scores had a reduced probability of looking at the conversational partner ( Sandgren et al, 2013 ).…”

“…In an effort to obtain a fuller picture of the communicative exchanges during referential communication—both speech and body communication—we recently fitted interlocutors with mobile eye trackers ( Sandgren et al, 2012 , 2013 , 2014 ). We were able to show that moments of mutual gaze, in which the listener looks at the speaker, showed a tight temporal connection with important parts of the spoken message ( Sandgren et al, 2012 ).…”

“…Since other factors than hearing differ between children with and without hearing impairment, we went on to investigate group differences in the probability of gaze to the speaker’s face while adjusting for individual performance on receptive grammar, expressive vocabulary, complex WMC, and phonological short term memory (PSTM; Sandgren et al, 2013 ). In the collected sample (cf.…”

Looking Behavior and Audiovisual Speech Understanding in Children With Normal Hearing and Children With Mild Bilateral or Unilateral Hearing Loss

“…Ricketts and Galster (2008) reported that children with hearing loss were more likely to turn toward brief utterances by secondary talkers in classrooms than were children with NH, and suggested that such attempts could have negative consequences if they draw attention away from the primary talker. Sandgren and colleagues (Sandgren et al 2013; 2014) reported that children with bilateral mild-moderate hearing loss were more likely to look at the face of their partner with NH during a dyadic referential communication task than vice versa. The same may be true for children with MBHL or UHL, for whom the auditory signal is degraded in a more chronic and persistent way than in peers with NH.…”