This study assessed the language skills, oral narrative abilities, and executive functions (EFs) of children who are deaf or hard of hearing (DHH) and normal hearing (NH), and examined the differences between two groups as well as the relationships between oral narrative production and EFs.
Eleven children who are DHH and ten who are NH, between 9 and 11 years of age, participated in the study. All of the children in the DHH group had bilateral hearing losses ranging from moderate through profound, and had no other diagnosed social, emotional or intellectual problems. All had more than 4 years 10 months of hearing experience with hearing aids or cochlear implants, used oral communication, and were educated in mainstreamed classrooms. The NH group included typically developing children with no diagnosed social, emotional or intellectual problems. Language ability was assessed by a standardized test and narrative microstructure analysis. Narratives were elicited through story retell and story generation, and measured their organization structures. EFs were assessed two ways. One was through parent report and the other was through performance based measures.
Results of the language assessments indicate that even though scores on the standardized language test were significantly different between groups, the language ability of the DHH group as assessed through microstructure analysis was generally comparable to their NH peers, and that they used their language knowledge appropriately at the discourse level. Their language ability was related to the well organized story structure in the story retell condition more than in the story generation condition. The macrostructure narrative analysis showed that the DHH group understood and produced age-appropriate story grammar and complete episodes, but had some problems in using their knowledge when making up their own stories. Their problems in presenting the logical relations of episodes on the story generation condition indicate that the DHH group may not fully understand the temporal and causal relationships between characters and events.
The correlations that were found between narrative structures and EFs with the DHH group support the idea that problems in narrative organization may be associated with EFs for this population. Although some relations were found between narrative macrostructures and EFs with the NH group, more EFs were implicated in the organization of narrative structures especially in story generation with the DHH group. This result indicates that EFs may have a greater influence on narrative organization for children who are DHH than those who are NH. Although the sample is limited and the results preliminary, the findings also suggest that the narrative problems seen in children who are DHH should be considered from both linguistic and cognitive perspectives in assessment and treatment
