Academic excellence for business and the professions
Reading and dyslexia in
deaf children
Dr Rosalind Herman
City University London
Childhood deafness
• 44,0004 children in the UK have a permanent
hearing loss
• A quarter have a severe-profound level of loss
that significantly impacts access to spoken
language
• Of these, approximately two thirds use spoken
language
4CRIDE
2012
Recent developments
Reading and deaf children
• Reading develops more slowly
• Reading delay increases with age5,6
• Are all deaf readers dyslexic?
• No, good deaf readers do exist7,8
• BUT some may be dyslexic
5Conrad
1979, 6Wauters et al. 2006, 7Marschark et al. 2007, 8Gravenstede & Roy 2009
Reading in deaf and hearing children
• Hearing children with reading difficulties are
likely to be diagnosed as dyslexic
• Deaf children’s difficulties are attributed solely
to their sensory loss
• Given the genetic basis of dyslexia2, might some
deaf children also be dyslexic?
1Allen,
1986; Conrad, 1979; Kyle & Harris, 2010; 2011; Wauters, van Bon &
Tellings, 2006; 2Pennington & Olson, 2005
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Why start with oral deaf children?
• Evidence reading develops in same way as
hearing children
• For both, phonological skills are important
– Hearing children rely on listening
– Deaf children additionally use lip-reading
(speechreading)9
9Kyle
& Harris 2010; 2011
Identification of dyslexia in deaf
readers: the challenges
• No tests for deaf children
• Can we use tests developed for hearing
children?
Phase 1: Oral deaf children
Phase
2:
Signing
deaf
children
Aims:
1. Investigate the suitability of literacy and
dyslexia-sensitive tests for deaf children
2. Collect data from a representative sample of
oral deaf children
3. Compare deaf readers to hearing children
with and without dyslexia
4. Find out if some deaf children have dyslexia
Participants in Phase 1
• 79 severely-profoundly children deaf from birth
• Year 6 (10-11years), primary education in English
• 61% cochlear implants, 39% digital hearing aids:
no difference in reading and phonological skills
so combined into one group
• Reference group of 20 hearing dyslexic children
Literacy
Vocabulary Measures Phonological
skills
Speech reading
Speech intelligibility
Non-verbal
Naming
speed
Test battery
 Literacy
– Single words, nonword reading, reading
comprehension, spelling
 Phonological tasks




–
–
–
–
–
Digit span
Fluency: rhyme, alliteration
Phoneme deletion (rein/deer)
Spoonerism (fun with “b”; riding boot)
Naming speed
Non verbal IQ
Expressive vocabulary
Speechreading and speech intelligibility
Familiar sequences
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Parent and teacher questionnaires
• Family history of speech/language, hearing, reading
problems
• Child’s hearing background, type of amplification
(hearing aid/cochlear implant), any additional
difficulties
• Parental education, ethnicity
• School and home communication method
• Methods used for teaching reading
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Could the children do the tests?
Deaf-friendly test administration:
listening conditions
• Quiet and distraction free test environment,
important for hearing aid/cochlear implant users
• Amplification fully functional prior to assessment
14
Deaf-friendly test administration:
visual access
• Optimal seating and lighting
• Access to clear speech patterns to support
speechreading
15
Tester skills
• Signing/gesture/writing used
as needed to explain tasks
• Additional practice items
offered where needed
• Sensitivity to deaf children’s
speech patterns in scoring
Note: all tests administered using
spoken language only in Phase 1
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Are deaf children with
cochlear implants better readers?
• 61% with implants
• 39% with hearing aids
• No differences between
groups
Differences among children with
cochlear implants
• Small group of children
implanted ≤18mths: no
below average scores
• Children implanted ≥2yrs:
mixed picture, good and
poor readers
Comparing deaf participants with hearing
test norms
• Deaf children had below average scores (<1SD) on most of the literacy and phonological
tasks
• Deaf children particularly poor on vocabulary
• Deaf children showed a normal spread of
scores on naming speed for digits, NVIQ,
speech reading, semantic fluency
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Comparing deaf and
hearing dyslexic children:
Single word reading
Hearing dyslexic children
Deaf children
30%
48%
52%
Average readers
Average readers
70%
Poor readers
Poor readers
Comparing deaf and
hearing dyslexic children:
Single word reading
Hearing dyslexic children
Deaf children
6%
Average readers
30%
Poor readers
42%
Average readers
52%
Extremely poor
readers
70%
Poor readers
Other literacy scores for deaf group
Reading comprehension:
• 39% deaf in normal range
Spelling:
• 60% deaf in normal range
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Evaluating our measures:
Predictors of literacy skills
Word
reading
• Vocabulary
• Phoneme deletion
Nonword
reading
• Phoneme deletion
• Spoonerisms
Spelling
• Vocabulary
• Naming speed for digits
Can we identify dyslexia in oral deaf
children?
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Classification of reading skills
Good language skills
Deaf 0%
Poor
decoding
skills
Deaf 48%
Deaf 30%
Dyslexic
readers
(PR)
Poor
readers,
poor
language
(PR + PL)
Average
readers
Average
readers,
poor
language
(PL)
Poor language skills
(Expressive vocabulary)
Good
decoding
skills
(Nonword reading)
Deaf 22%
Deaf children’s range of scores on single
word reading and vocabulary
Deaf children compared with hearing
dyslexic children
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Can we separate poor reading from
language difficulties in deaf children?
Can we separate poor reading from language
difficulties in deaf children?
What about deaf children’s
phonological skills?
Comparing deaf children and hearing dyslexic
children with below average scores
Literacy, language and
phonological scores
Hearing dyslexic children:
% Below average literacy scores
Deaf and hearing dyslexic children:
% Below average literacy scores
Deaf and hearing dyslexic children:
% Below average language and
comprehension scores
60
40
20
0
Reading comprehension
Vocabulary
Deaf
Hearing dyslexic
Deaf and hearing dyslexic children:
Below average phonological skills
Spelling errors:
Use of phonological route?
Types of spelling errors:
phonetic error ‘lepered’
non-phonetic ‘cuircle’
Spelling errors:
Use of phonological route?
Better literacy
Poorer literacy
Why do deaf children have reading problems?
The role of early language experience
Limited early
language
experience
Poor speech perception
and production
Poor vocabulary
development
Poor phonological
representations and
awareness
Poor reading
Inefficient word learning
So were any deaf readers dyslexic?
Poor readers
Average
readers
6% ‘extremely poor’ deaf readers:
• severe phonological deficits
• lowest scores across all measures
We cannot tell if they have dyslexia
Their response to intervention may be
informative
We looked at all poor deaf readers’
performance on measures that identified
poor reading in the hearing dyslexic group
40
Naming speed a key measure in
identifying dyslexia
Eight deaf children with average speech intelligibility and nonverbal
scores BUT low scores on naming speed
Three with average non-word reading unlikely to be dyslexic
41
Of the five remaining, all had:
– Very poor spelling (phonetic spelling errors)
– Very poor phonological skills (spoonerisms, phoneme
deletion)
– Very poor sequencing skills (months in correct sequence)
– 4/5 were boys
These children fit the
typical dyslexic profile
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Phase 1: Conclusions
Some oral deaf children do have a dyslexic
profile BUT these are not the only poor readers
Half* our oral deaf sample are poor readers, all
with poor language and weak phonological
skills
The phonological deficits are the same as those
found in hearing children with dyslexia
*Using more recent norms for BAS single word reading
test, 71% are poor readers
What happens next?
 These children are poorly equipped for secondary school
 All poor deaf readers need support not just the few
with dyslexia
Interventions that work with hearing dyslexic children
should be available to poor deaf readers
Like hearing children with severe reading difficulties, deaf
children need intensive, individualised, ongoing
interventions to address their language and phonological
deficits
Ideally, intervention should be early to prevent these
problems
Breaking the cycle
Through learning to
read and spell,
children can develop
their phonological
awareness skills and
extend their
vocabularies
Phase 2: Deaf signing children
Questions we hope to answer
What does a good reader in this group look like using
our tests?
If signing helps language development, is reading better
among children with good signing skills?
Are phonological skills important to reading in signers?
What is the profile of good and poor readers?
Is there a dyslexic profile among signers?
What might help reading development in signers who
struggle with reading?
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The Rose Report, 2009
“the Government wants every child to
succeed…the ability to read well is key to
success in education and an essential life
skill… (the need for) high quality provision
for securing literacy for all children”
What about deaf
children?
Acknowledgements
Thanks to…
 My collaborators, Penny Roy & Fiona Kyle
The Nuffield Foundation
 All the children, families and schools who took part
Our research assistants: Zoe Shergold for phase 1 and
Catherine Barnett for phase 2
 Advisory group: Sue Brownson, Margaret Harris, Mairead
MacSweeney, Barbara Maughan, Ian Noon, Kate Rowley,
Karen Simpson, Maggie Snowling, Ruth Swanwick & Tyron
Woolfe
 r.c.herman@city.ac.uk
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