Lexical-Semantic Access and Organization in Children who are Hard of Hearing: Evidence from Verbal Fluency Tasks

Language acquisition is complex. Auditory access supports spoken language acquisition. Children with hearing loss have limited auditory access and therefore are at risk for poorer language outcomes compared to typical hearing peers. Because children who are hard of hearing (HH) develop language via degraded auditory input, they have reduced access to the fine-grained phonological information that comprises words. Their limited auditory access can also cause children who are HH to hear words in fewer semantic contexts than children with typical hearing (TH). These differences in phonological sensitivity and semantic knowledge may lead to weaker lexical-semantic representations in children who are HH. The current study uses a verbal fluency task to address the following research questions: (1) do children who are HH and children who are TH differ in their lexical-semantic organization, (2) do children who are HH and children who are TH differ in their use of phonological and semantic clustering strategies, and (3) what is the effect of age on verbal fluency performance for children who are HH and children who are TH? We predict children who are HH to generate fewer words in both phonemic and semantic verbal fluency subtests and use semantic strategies more than children who have TH, exposing an effect of age for only children who have TH. Eighteen children who are TH and 25 children who are HH completed a verbal fluency task. Results partially supported our predictions; similar performance in total words, clusters and cluster size, and clustering strategy while there was a moderate effect on age for children who are TH only. A better understanding of the underlying lexical-semantic organization system in children who are HH will inform more effective treatment approaches, which could carry over to improved literacy and academic success.