Date of Award:

12-2011

Document Type:

Dissertation

Degree Name:

Doctor of Philosophy (PhD)

Department:

School of Teacher Education and Leadership

Department name when degree awarded

Education (Research and Evaluation)

Committee Chair(s)

Karl R. White

Committee

Karl R. White

Committee

Lisa K. Boyce

Committee

Timothy A. Slocum

Committee

Patricia S. Moyer-Packenham

Committee

Carol J. Strong

Abstract

This study included a comprehensive review of the literature in which the effects of early identification of hearing loss and intervention on language outcomes were investigated. Previous reviews of studies were not comprehensive in their coverage and did not include a common measure for comparing results across studies. Without a more rigorous analysis of the primary research, conclusions drawn from these reviews are tenuous. The review of primary studies showed they exhibit many methodological problems including weak experimental designs, small sample sizes, attrition or questionable sample selection methods, differences in length of treatment and characteristics of the participants, and inadequate reporting. Many researchers unjustifiably concluded that earlier intervention produced better developmental outcomes. Additionally, almost half of the studies in which children with hearing loss were assessed at older ages showed no or small relationships between age at identification or intervention and language outcomes.

Structural Equation Modeling (SEM), a statistical method that can be used to explore relationships among variables, was used with a large existing database to further investigate the relationship between age at identification of hearing loss or intervention and child outcomes. Characteristics of the data, including large amounts of missing data and data that did not meet other conditions needed for the SEM, made the data unsuitable for this statistical method. Analyses resulted in inadequate model fit indices and unreasonable parameter estimates. As such, these statistical analysis techniques did not result in findings from which we can draw conclusions to contribute to the research.

To conclude, we know too little about whether earlier identification and intervention improves later language outcomes for children born with hearing loss. In addition to stronger research designs with sufficient sample sizes, use of reliable measures to collect a broader array of data related to important factors that may affect outcomes, and better measurement of intervention characteristics, perhaps we should also be asking different questions. We need to know more about which interventions, in what order, provided by whom, and in what ways to have the greatest impact on language outcomes. These children with hearing loss, like so many other struggling children, do not have the luxury of time. In order to help them maximize their potential and be successful and productive in our society, we need to conduct better research on the efficacy of interventions now. For them, time is of the essence.

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Comments

Publication made available electronically December 21, 2011.

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