1. Development of Rhyming Tasks in Preschool Aged Children with Hearing Loss Mary Katherine Connelly, Kaylie McNally Joan A. Luckhurst, Ph.D., CCC/SLP, faculty advisor Abstract Numerous studies have shown that children with hearing loss are at significant disadvantage in regards to skills required for reading. Rhyming has been shown to be a strong indicator of early literacy development. This study examines the relationship between rhyming skills to 1) the degree of hearing loss, and 2) listening device type. Results showed no significant difference in rhyming skills in relation to either condition. Background Research shows that rhyming is a good indicator of a child’s phonological awareness (Fiona & Harris, 2012). Phonological awareness refers to, “a broad class of skills that involve attending to, thinking about, and intentionally manipulating the phonological aspects of spoken language, especially the internal phonological structure of words” (Easterbrooks, Lederberg, Miller, Bergeron & Connor, 2008, p. 92). Many studies have established that phonological awareness is strongly related to, and even a good predictor of reading abilities and literacy in young hearing children (Webb & Lederberg, 2014). This is due to the fact that it is essential for matching speech and alphabetic knowledge (Webb & Lederberg, 2014). Phonological awareness has not been shown to be a good predictor for children with minimal or no functional hearing, but children with hearing loss who have greater functional hearing may demonstrate skills more consistent with hearing children’s results (Webb & Lederberg, 2014). For example, Fiona and Harris (2012) found that children with smaller reading delays tended to have better levels of hearing. Spencer and Tomblin (2009) investigated phonological skills in children using cochlear implants. They conducted a rhyme test in which the evaluator named the pictures and the participant had to choose the picture that rhymed with the cue word (Spencer & Tomblin, 2009). Results showed that the cochlear implant (CI) users scored lower than their hearing peers, averaging 85% accuracy in comparison to 93% for hearing peers. The average age for this group was eleven years and nine months. Few studies on rhyming skills have examined the differences between hearing aid (HA) users and CI users in relation to these skills. The current study aimed to examine rhyming skills in a much younger group (4-year-old preschool children) with varying degrees of hearing loss, and to compare skills between HA users and CI users. La Salle University Department of Communication Sciences and Disorders Purpose The purpose of this study was to examine the relationship between hearing loss and rhyming skills in preschoolers with hearing loss. The study involved two experiments, one examining whether rhyming skills and degree of loss were significantly related and the second examining whether device type was significantly related to rhyming skills. Participants Archived data on a small group of participants from a larger study was examined. Participants included nine children with hearing loss between the ages 4 years 3 months and 4 years 10 months (mean age of 4 years 6 months) who attended a preschool program for children with hearing loss. The program used a state-approved preschool curriculum focused on development of listening and spoken language. Children participated in a full day preschool program, with daily individual speech-language pathology services. Four participants had profound hearing loss and used CIs (1 female, 3 males) and five had hearing loss ranging from mild to moderate-severe and used HAs (1 female, 4 males). See Table 1 for demographic information. Methods Rhyme awareness test results from The Rhyme Awareness subtest of the Phonological Awareness for Literacy Screening (PALS) were used. The PALS is a criterion referenced screening test of phonological awareness that assesses sound awareness, letter- sound knowledge, sound-symbol association, and rhyming (Invernizzi, Sullivan, & Meier, 2001). The rhyming task requires the evaluator to present each child with a picture of a word. The examiner names the word and asks the child to repeat it. The examiner then presents pictures of three other words, naming each of them, and asks the child which word rhymes with or “sounds like” the first word. The highest score a child can receive is 10. For this study, group means and analysis of variance (ANOVA) were used to determine whether there was a significant relation between rhyming skills and 1) degree of hearing loss or 2) device type. Data was entered into SPSS to complete the analysis. Level of significance for results was set at p<0.05. Experiment 1: Null Hypothesis was, There is no significant difference in rhyming skills by degree of hearing loss. Raw scores on the rhyming task of the PALS were compared to the degree of hearing loss. Degree of hearing loss was assigned the following values for comparison: 1 = mild, 2 = moderate, 3 = severe to profound. Experiment 2: Null Hypothesis: There is no significant difference in rhyming skills by type of assisted listening device. Raw scores on the rhyming task of the PALS were compared to type of device used. Device type was coded as follows: HA = 1; CI = 2. Results: Experiment 1: The hypothesis was that if a child has a greater degree of hearing loss, then he/she will have a lower raw score on the rhyming section of the PALS. 1 participant had mild HL, 1 had moderate HL, 3 had severe HL, and 4 had profound HL. Participants’ rhyming scores ranged from 0 – 10, with a mean of 3.89 and standard deviation of 3.14. Results showed that there was no significant difference between rhyming scores by degree of hearing loss (f =. 345; p =.721). Experiment 2: The hypothesis was that if a child uses a CI, then he/she will have a lower score on the rhyming section of the PALS than a HA user. 4 participants were CI users; 5 were HA users. Results showed that there was no significant difference in rhyming skills by type of device used (f =.084; p =.780). Discussion While results of these two experiments showed no significant difference in rhyming skills based on degree of hearing loss or device type, there were several significant limitations that may have impacted outcomes. First, the sample size of this study was very small, as it only had nine participants. Second, only two out of the nine participants were female and only two were from a lower socioeconomic status, thereby limiting the ability to draw conclusions about the impact of gender and SES on development of rhyming skills. Previous research has suggested that both gender and SES status are significant factors in acquisition of phonological awareness skills, including rhyming (Lundberg, Larsman, & Stridd, 2010) Third, all but one participant had non-verbal cognitive skills within the average to above average range (see Table 1). Therefore, differences in non-verbal cognitive skills could not be examined in this study. Finally, numbers of participants for each level of hearing loss was also too small to generalize results in any way. The authors feel, however, that results of this small study suggest the need for replication with larger and more diverse groups of preschool children with hearing loss. Previous research with older children and with other groups of children with hearing loss have suggested that both device type and degree of hearing loss have significant impact on development of phonological awareness skills, including rhyming (James, Raijput, Brown, Sirimanna, Brinton, & Goswami, 2005). This small study contradicted that. This could suggest that early identification and intervention of children with hearing loss strongly mitigates effects on development of phonological awareness, specifically rhyming skills. Data for this study was from participants who were identified and provided with assistive listening devices and received early intervention focused on the development of listening and spoken language by two years of age. Participant Data Agesex Mother ed level Degree HL Device Type Rhyme Raw Score Duration of use HA (yrs) Duration of use CI (yrs) NV Cog Skills Student 14.09FM.S.ProfCI032107 Student 24.08MB.S./B.A.ProfCI103299 Student 34.05MB.S./B.A.ProfCI54399 Student 44.05MSome collegeProfCI232104 Student 54.08MB.S/B.A.MildHA63n/a118 Student 64.06F12 th grade Mod- sev HA43n/a110 Student 74.04MSome college Mod- sev HA31n/a101 Student 84.10M Some high school Mod- sev HA52n/a95 Student 94.03MM.S.modHA02n/a72 Table 1 References: Easterbrooks, S., Lederberg, A., Miller, E., Bergeron, J., & Connor, C. M. (2008). Emergent literacy skills during early childhood in children with hearing loss: Strengths and weaknesses. The Volta Review 108 (2), 91-114. Fiona, K. E., & Harris, M. (2012, June ). 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