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Reading and dyslexia in deaf children

Reading and dyslexia in deaf children. Dr Rosalind Herman City University London. Childhood deafness. 44,000 4 children in the UK have a permanent hearing loss A quarter have a severe-profound level of loss that significantly impacts access to spoken language

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Reading and dyslexia in deaf children

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  1. Reading and dyslexia in deaf children Dr Rosalind Herman City University London

  2. Childhood deafness • 44,0004children in the UK have a permanent hearing loss • A quarter have a severe-profound level of loss that significantly impacts access to spoken language • Of these, approximately two thirds use spoken language 4CRIDE 2012

  3. Recent developments

  4. Reading and deaf children • Reading develops more slowly • Reading delay increases with age5,6 • Are all deaf readers dyslexic? • No, good deaf readers do exist7,8 • BUT some may be dyslexic 5Conrad 1979, 6Wauters et al. 2006, 7Marschark et al. 2007, 8Gravenstede & Roy 2009

  5. Reading in deaf and hearing children • Hearing children with reading difficulties are likely to be diagnosed as dyslexic • Deaf children’s difficulties are attributed solely to their sensory loss • Given the genetic basis of dyslexia2, might some deaf children also be dyslexic? 1Allen, 1986; Conrad, 1979; Kyle & Harris, 2010; 2011; Wauters, van Bon & Tellings, 2006; 2Pennington & Olson, 2005

  6. Why start with oral deaf children? • Evidence reading develops in same way as hearing children • For both, phonological skills are important • Hearing children rely on listening • Deaf children additionally use lip-reading (speechreading)9 9Kyle & Harris 2010; 2011

  7. Identification of dyslexia in deaf readers: the challenges No tests for deaf children Can we use tests developed for hearing children?

  8. Phase 1: Oral deaf children Phase 2: Signing deaf children Aims: • Investigate the suitability of literacy and dyslexia-sensitive tests for deaf children • Collect data from a representative sample of oral deaf children • Compare deaf readers to hearing children with and without dyslexia • Find out if some deaf children have dyslexia

  9. Participants in Phase 1 • 79 severely-profoundly children deaf from birth • Year 6 (10-11years), primary education in English • 61% cochlear implants, 39% digital hearing aids: no difference in reading and phonological skills so combined into one group • Reference group of 20 hearing dyslexic children

  10. Measures Literacy Vocabulary Phonological skills Non-verbal Naming speed Speech reading Speech intelligibility

  11. Test battery • Literacy • Single words, nonword reading, reading comprehension, spelling • Phonological tasks • Digit span • Fluency: rhyme, alliteration • Phoneme deletion (rein/deer) • Spoonerism (fun with “b”; riding boot) • Naming speed • Non verbal IQ • Expressive vocabulary • Speechreading and speech intelligibility • Familiar sequences

  12. Parent and teacher questionnaires • Family history of speech/language, hearing, reading problems • Child’s hearing background, type of amplification (hearing aid/cochlear implant), any additional difficulties • Parental education, ethnicity • School and home communication method • Methods used for teaching reading

  13. Could the children do the tests?

  14. Deaf-friendly test administration: listening conditions • Quiet and distraction free test environment, important for hearing aid/cochlear implant users • Amplification fully functional prior to assessment

  15. Deaf-friendly test administration: visual access • Optimal seating and lighting • Access to clear speech patterns to support speechreading

  16. Tester skills • Signing/gesture/writing used as needed to explain tasks • Additional practice items offered where needed • Sensitivity to deaf children’s speech patterns in scoring Note: all tests administered using spoken language only in Phase 1

  17. Are deaf children with cochlear implants better readers? • 61% with implants • 39% with hearing aids • No differences between • groups

  18. Differences among children with cochlear implants • Small group of children implanted ≤18mths: no below average scores • Children implanted ≥2yrs: mixed picture, good and poor readers

  19. Comparing deaf participants with hearing test norms • Deaf children had below average scores (<-1SD) on most of the literacy and phonological tasks • Deaf children particularly poor on vocabulary • Deaf children showed a normal spread of scores on naming speed for digits, NVIQ, speech reading, semantic fluency

  20. Comparing deaf and hearing dyslexic children:Single word reading

  21. Comparing deaf and hearing dyslexic children: Single word reading

  22. Other literacy scores for deaf group Reading comprehension: • 39% deaf in normal range Spelling: • 60% deaf in normal range

  23. Evaluating our measures: Predictors of literacy skills

  24. Can we identify dyslexia in oral deaf children?

  25. Classification of reading skills Good language skills Deaf 30% Deaf 0% Poor Good decoding decoding skills skills (Nonword reading) Deaf 22% Deaf 48% Poor language skills (Expressive vocabulary)

  26. Deaf children’s range of scores on single word reading and vocabulary

  27. Deaf children compared with hearing dyslexic children

  28. Can we separate poor reading from language difficulties in deaf children?

  29. Can we separate poor reading from language difficulties in deaf children?

  30. What about deaf children’s phonological skills?

  31. Comparing deaf children and hearing dyslexic children with below average scores Literacy, language and phonological scores

  32. Hearing dyslexic children: % Below average literacy scores

  33. Deaf and hearing dyslexic children: % Below average literacy scores

  34. Deaf and hearing dyslexic children: % Below average language andcomprehension scores

  35. Deaf and hearing dyslexic children: Below average phonological skills

  36. Spelling errors: Use of phonological route? Types of spelling errors: phonetic error ‘lepered’ non-phonetic ‘cuircle’

  37. Spelling errors: Use of phonological route? Better literacy Poorer literacy

  38. Why do deaf children have reading problems? The role of early language experience • Poor vocabulary development Poor reading

  39. So were any deaf readers dyslexic? • 6% ‘extremely poor’ deaf readers: • severe phonological deficits • lowest scores across all measures • We cannot tell if they have dyslexia • Their response to intervention may be informative Poor readers Average readers

  40. We looked at all poor deaf readers’ performance on measures that identified poor reading in the hearing dyslexic group

  41. Naming speed a key measure in identifying dyslexia Eight deaf children with average speech intelligibility and nonverbal scores BUT low scores on naming speed • Three with average non-word reading unlikely to be dyslexic

  42. Of the five remaining, all had: • Very poor spelling (phonetic spelling errors) • Very poor phonological skills (spoonerisms, phoneme • deletion) • Very poor sequencing skills (months in correct sequence) • 4/5 were boys These children fit the typical dyslexic profile

  43. Phase 1: Conclusions • Some oral deaf children do have a dyslexic profile BUT these are not the only poor readers • Half* our oral deaf sample are poor readers, all with poor language and weak phonological skills • The phonological deficits are the same as those found in hearing children with dyslexia *Using more recent norms for BAS single word reading test, 71% are poor readers

  44. What happens next? • These children are poorly equipped for secondary school • All poor deaf readers need support not just the few with dyslexia • Interventions that work with hearing dyslexic children should be available to poor deaf readers • Like hearing children with severe reading difficulties, deaf children need intensive, individualised, ongoing interventions to address their language and phonological deficits • Ideally, intervention should be early to prevent these problems

  45. Breaking the cycle Through learning to read and spell, children can develop their phonological awareness skills and extend their vocabularies

  46. Phase 2: Deaf signing children Questions we hope to answer • What does a good reader in this group look like using our tests? • If signing helps language development, is reading better among children with good signing skills? • Are phonological skills important to reading in signers? • What is the profile of good and poor readers? • Is there a dyslexic profile among signers? • What might help reading development in signers who struggle with reading?

  47. The Rose Report, 2009 What about deaf children? “the Government wants every child to succeed…the ability to read well is key to success in education and an essential life skill… (the need for) high quality provision for securing literacy for all children”

  48. Acknowledgements Thanks to… • My collaborators, Penny Roy & Fiona Kyle • The Nuffield Foundation • All the children, families and schools who took part • Our research assistants: Zoe Shergold for phase 1 and Catherine Barnett for phase 2 • Advisory group: Sue Brownson, Margaret Harris, Mairead MacSweeney, Barbara Maughan, Ian Noon, Kate Rowley, Karen Simpson, Maggie Snowling, Ruth Swanwick & Tyron Woolfe • r.c.herman@city.ac.uk

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