Mother-child shared reading improves the language abilities and brain functions in young children with hearing loss

• In Event: Effects of Early Experience and Intervention on Children’s Brain Development: Empirical Insights and Educational Implications

Abstract

Background
Children with hearing loss (HL) often face literacy delays, achieving academic levels comparable to third or fourth-graders without adequate intervention (Walker et al., 2020). Traditional methods for improving auditory and language abilities in young children with HL have shown limitations. Since over 95% of parents of children with HL have normal hearing, the home environment presents a unique opportunity for language development (Mitchell & Karchmer, 2004). Early family-based interactions, such as shared book reading (SBR), have proven beneficial for enhancing auditory and language abilities in children without HL (Zhai et al., 2023). However, the specific benefits of mother-child SBR for children with HL and associated brain changes remain unclear.
Objectives
This study aimed to assess the impact of mother-child SBR on the auditory and language abilities of young children (aged 2-6 years) with HL and to identify the brain mechanisms underlying these effects.

Methods
A total of 180 children aged 2-6 years (mean age 3.981 ± 1.021 years) and their mothers participated in a 6-month SBR intervention project. The mother-child dyads engaged in daily SBR sessions. Latent Profile Analysis (LPA) was used to categorize SBR practices, resulting in 70 HL children being assigned to the intervention group (SBR+), 48 HL children to a non-intervention group (SBR-), and 62 typically developing children with normal hearing (NH) serving as a control group (CTR). Auditory and language abilities were assessed before and after the intervention, and brain responses to auditory and language stimuli were examined using functional Near-Infrared Spectroscopy (fNIRS).

Results
Before the intervention, HL children showed weaker auditory and language abilities compared to the NH group (ps < 0.001), with no significant differences between the SBR+ and SBR- groups (ps > 0.05). Following the intervention, the SBR+ group demonstrated significant improvements in recognition of phonemes and numbers, speech intelligibility, vocabulary size, and comprehension ability compared to the SBR- group. Additionally, prior to the intervention, both HL groups exhibited reduced brain sensitivity to all stimuli in core brain regions, including the sensorimotor and auditory cortex (SMAC), temporoparietal junction (TPJ), and prefrontal cortex (PFC). Post-intervention, the SBR+ group displayed a distinct compensatory response in the left temporoparietal junction (TPJ) to auditory and language stimuli, differing from both the SBR- (F = 4.532, p = 0.011) and CTR (F = 2.357, p = 0.016) groups. The left TPJ, typically more involved in mutual understanding (story listening) than in direct language processing (sentence listening), showed heightened sensitivity to stimuli with richer information and larger time scales.

Implications
This study highlights the crucial role of family-based naturalistic interventions, such as mother-child SBR, in advancing auditory and language development in children with HL. The intervention not only significantly enhances these abilities but also indicates a unique compensatory mechanism in the brain, particularly in the left TPJ, which might be essential for processing complex auditory and linguistic information. Incorporating such interventions into early developmental practices can empower parents to effectively support their children's language and auditory skills, potentially leading to better long-term academic and social outcomes.

Authors

• Yu Zhai, Beijing Normal University

• Yajing Xing, Beijing Normal University

• Chenchen Xu, Beijing Normal University

• Xiangyu He, Beijing Normal University

• Chunming Lu, Beijing Normal University