The effects of visuospatial sequence training with children who are deaf or hard of hearing

Despite advances in hearing aid and cochlear implant technologies, many children who are deaf or hard of hearing continue to lag behind typically hearing peers in language and reading abilities. Additionally, there is a high degree of variability in language outcomes among children with a hearing loss. Evidence indicates that auditory input provides a foundation not only for speech and language development but for cognitive functions such as sequence memory and learning ability. This study investigated a variety of cognitive functions with two major aims in mind: (1) to verify differences between children who are deaf or hard of hearing and typically hearing children on variety of cognitive tasks, (2) to determine if visuospatial sequencing practice would result in improvements on nontrained tasks measuring phonological memory, sequencing ability, and executive function.;Thirty-two children who were deaf or hard of hearing and 29 children with typical hearing took part in this study. One pretraining and two post training sessions assessed cognitive tasks involving visuospatial short-term memory; verbal short-term memory (nonword repetition); inhibition; and visual sequence learning. Pretraining assessments revealed significant differences between the groups on verbal tasks with both auditory and visual stimuli as well as on tasks of inhibition and visual sequencing. In addition, differences were revealed on visual tasks with nonverbal stimuli. These findings suggest a general difference or delay in performance beyond the anticipated verbal delay related to a deficit in hearing acuity. The training task utilized a touch screen computer monitor that displayed sequences of circles on a 4 x 4 grid which subjects then replicated. Subjects were age matched and completed ten days of visuospatial sequencing practice in either an adaptive or control condition. Two post training assessment sessions revealed improvement on the nonword repetition task for the adaptive group following the sequencing practice. These findings suggest that visuospatial sequencing practice can lead to improvements in language abilities. Possible applications include utilizing measures of visual sequencing ability to identify deaf or hard of hearing children who may be at risk for poorer language development and as a component in predicting successful language development following cochlear implantation.