Comprehension Strategies for Children with Hearing Loss

“How many people got all 10 answers right?” No hands went up. “Nine?” One solitary person across the room raised her hand.

As Susan Lenihan, Ph.D., counted backward to numbers seven and six, a number of hands shot up on the other side of the room. People sitting at the table around me looked quizzically at each other. It wasn’t until Lenihan asked who had three right answers that people on my side of the room began raising their hands.

In a group of approximately 40 speech-language pathologists, audiologists and teachers of the deaf, half of them had difficulty answering questions about sentences the presenter had just read to them. Were they not paying attention?

Lenihan, director of the deaf education program at Fontbonne University, quickly jumped in with an explanation. Everyone in the room had been asked to listen to a series of sentences, but the written instructions given to the people on the other side of the room directed them to imagine a vivid picture of what was happening in each sentence.

The people at my table looked down and reread the instructions we had received:
“Please rate the sentences I will read aloud on how easily you can pronounce them. Repeat the sentences silently to yourself.”

The exercise, part of the Talk for a Lifetime Summer Conference learning lab “Classroom Techniques to Enhance Language for Literacy,” was designed to demonstrate what happens when children — and adults — are required to spend more brain power on thinking about the sounds in a sentence rather than understanding what those words actually mean.

Lenihan outlined four components of text comprehension as described by Estabrooks and Estes (2007):

  1. The ability to rapidly decode and attach meaning to new words,
  2. The syntactic and morphologic competence to gain collective meaning from the decoded words,
  3. The ability to hold the meaning in working memory while processing new words and
  4. The ability to apply text processing strategies for the purpose of figuring out unfamiliar words and passages.

She then asked what gets in the way of each of these components when children who are deaf engage in reading. The answers that followed seemed like basic common sense, but they still served as good reminders of why it is so important for children with hearing loss to receive early amplification and intensive support for spoken language development if they are to become fluent readers.

Put simply, children with typical hearing listen to the people around them and automatically begin to imitate the sounds they hear. Children who cannot hear sounds have little or no phonemic awareness, so they have difficulty understanding how words break down into syllables. For those children, the words “good night” from their parents might be heard only as vowels. What does “oo ai” mean to you? The sounds missed by children with hearing loss affect the development of an accurate auditory memory.

Another common problem encountered by children with hearing loss is difficulty attaching meaning to words. This circumstance can be caused by a mismatch between spoken language and reading levels (often delayed initially due to auditory deprivation) and education level. For children who use American Sign Language (ASL), an additional factor is involved, as ASL visual cues do not correspond on a one-to-one basis to the sounds of spoken and written English.

Ultimately, children with hearing loss have missed out on a significant amount of auditory information, background knowledge that is more readily available to children with typical hearing. With a more limited “fund of knowledge” to pull from, they may not be able to fill in gaps when unfamiliar words or ideas appear on a printed page.

It is not enough, however, to comprehend the difficulties with language these children may experience; it also is critical to understand the process of reading comprehension. Lenihan has created a “cheat sheet” based on a 1998 RAND Reading Study Group as a jumping-off point for her classes and as a useful reminder for professionals working with children and families. According to the list, teachers should model comprehension strategies, integrate those strategies into classroom subject matter and give students choices and collaborative learning opportunities to increase their motivation.

Lenihan also thinks it is important to remember a key finding from the original study: “Despite the well-developed knowledge base supporting the value of instruction designed to enhance comprehension, comprehension instruction continues to receive inadequate time and attention in typical classroom instruction.” (Snow, Griffin and Burns, 2005)

So how does one ensure that children with hearing loss learn reading comprehension strategies? Research summarized by Snow, Griffin and Burns (2005) encourages conversations with peers and grown-ups before, during and after read-aloud time to nurture literacy, as well as routine conversations with expert communicators such as teachers, peers and parents to help children develop their background knowledge of the language. They also encourage development of phonemic awareness in meaningful contexts through wordplay activities, such as reading in character and using interactive books.

Of course, children also can be encouraged to create vivid mental images of the words as they read, such as some in Lenihan’s learning lab were instructed to do. If the number of hands that were raised on the other side of the room were any indication, this simple technique appears to be one that works.

Source: Volta Voices, 2007