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Factors Associated with Social-Pragmatic Understanding in Deaf and Hard of Hearing and Typically Hearing 6-Year-Old Children

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Title: Factors Associated with Social-Pragmatic Understanding in Deaf and Hard of Hearing and Typically Hearing 6-Year-Old Children
Language: English
Authors: Krista Tuohimaa (ORCID 0000-0002-3461-5906), Soile Loukusa (ORCID 0000-0001-6614-4689), Heikki Löppönen (ORCID 0000-0002-2002-5358), Antti A. Aarnisalo (ORCID 0000-0002-0138-8532), Aarno Dietz (ORCID 0000-0001-6076-1037), Antti Hyvärinen (ORCID 0000-0001-6672-5109), Jaakko Laitakari (ORCID 0000-0001-9768-5074), Satu Rimmanen, Jaakko Salonen (ORCID 0000-0003-1023-5674), Ville Sivonen (ORCID 0000-0001-5881-6553), Tanja Tennilä, Teija Tsupari, Sari Vikman, Nonna Virokannas, Johanna Hautala, Anna-Kaisa Tolonen, Taina Välimaa (ORCID 0000-0002-4826-6401), Sari Kunnari (ORCID 0000-0001-5290-4851)
Source: Journal of Speech, Language, and Hearing Research. 2025 68(2):808-826.
Availability: American Speech-Language-Hearing Association. 2200 Research Blvd #250, Rockville, MD 20850. Tel: 301-296-5700; Fax: 301-296-8580; e-mail: slhr@asha.org; Web site: http://jslhr.pubs.asha.org
Peer Reviewed: Y
Page Count: 19
Publication Date: 2025
Document Type: Journal Articles
Reports - Research
Descriptors: Hard of Hearing, Deafness, Sensory Aids, Young Children, Language Usage, Pragmatics, Interpersonal Competence, Demography, Cognitive Ability, Foreign Countries, Language Skills
Geographic Terms: Finland
DOI: 10.1044/2024_JSLHR-23-00574
ISSN: 1092-4388
1558-9102
Abstract: Purpose: Children develop social-pragmatic understanding with the help of sensory, cognitive, and linguistic functions by interacting with other people. This study aimed to explore (a) associations between auditory, demographic, cognitive, and linguistic factors and social-pragmatic understanding in children who use bilateral hearing aids (BiHAs) or bilateral cochlear implants (BiCIs) and in typically hearing (TH) children and (b) the effect of the group (BiHA, BiCI, TH) on social-pragmatic understanding when the effects of demographic, cognitive, and linguistic factors are controlled for. Method: The Pragma test was used to assess social-pragmatic understanding in 119 six-year-old children: 25 children who use BiHAs, 29 who use BiCIs, and 65 TH children. The Pragma test is a standardized test that requires answering socially and contextually demanding questions with varying focuses and thus enables a comprehensive assessment of social-pragmatic understanding. Associations between auditory, demographic, cognitive, and linguistic factors and the Pragma test performance were analyzed. Between-groups differences in the Pragma test performance were analyzed while statistically controlling for the effects of factors that were associated with the Pragma test scores. Results: The BiHA users who had better unaided pure-tone average hearing thresholds had better social-pragmatic understanding. A higher level of maternal education and nonverbal intelligence were associated with a better social-pragmatic understanding in the BiHA and BiCI groups. Linguistic abilities correlated strongly with social-pragmatic understanding in all groups. The deaf and hard of hearing (DHH) groups differed from the TH children in social-pragmatic understanding even after the effects of maternal education, nonverbal intelligence, and linguistic skills were controlled for. Conclusions: Despite early diagnosis of hearing loss and intervention, many DHH children are still at risk for social-pragmatic difficulties. Several factors may associate with social-pragmatic understanding in DHH children, which highlights the importance of a wide-ranging, multidisciplinary assessment, and the planning of focused, assessment-based interventions.
Abstractor: As Provided
Entry Date: 2025
Accession Number: EJ1463056
Database: ERIC
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  Data: Factors Associated with Social-Pragmatic Understanding in Deaf and Hard of Hearing and Typically Hearing 6-Year-Old Children
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  Data: English
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  Data: <searchLink fieldCode="AR" term="%22Krista+Tuohimaa%22">Krista Tuohimaa</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-3461-5906">0000-0002-3461-5906</externalLink>)<br /><searchLink fieldCode="AR" term="%22Soile+Loukusa%22">Soile Loukusa</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-6614-4689">0000-0001-6614-4689</externalLink>)<br /><searchLink fieldCode="AR" term="%22Heikki+Löppönen%22">Heikki Löppönen</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-2002-5358">0000-0002-2002-5358</externalLink>)<br /><searchLink fieldCode="AR" term="%22Antti+A%2E+Aarnisalo%22">Antti A. Aarnisalo</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-0138-8532">0000-0002-0138-8532</externalLink>)<br /><searchLink fieldCode="AR" term="%22Aarno+Dietz%22">Aarno Dietz</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-6076-1037">0000-0001-6076-1037</externalLink>)<br /><searchLink fieldCode="AR" term="%22Antti+Hyvärinen%22">Antti Hyvärinen</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-6672-5109">0000-0001-6672-5109</externalLink>)<br /><searchLink fieldCode="AR" term="%22Jaakko+Laitakari%22">Jaakko Laitakari</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-9768-5074">0000-0001-9768-5074</externalLink>)<br /><searchLink fieldCode="AR" term="%22Satu+Rimmanen%22">Satu Rimmanen</searchLink><br /><searchLink fieldCode="AR" term="%22Jaakko+Salonen%22">Jaakko Salonen</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-1023-5674">0000-0003-1023-5674</externalLink>)<br /><searchLink fieldCode="AR" term="%22Ville+Sivonen%22">Ville Sivonen</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-5881-6553">0000-0001-5881-6553</externalLink>)<br /><searchLink fieldCode="AR" term="%22Tanja+Tennilä%22">Tanja Tennilä</searchLink><br /><searchLink fieldCode="AR" term="%22Teija+Tsupari%22">Teija Tsupari</searchLink><br /><searchLink fieldCode="AR" term="%22Sari+Vikman%22">Sari Vikman</searchLink><br /><searchLink fieldCode="AR" term="%22Nonna+Virokannas%22">Nonna Virokannas</searchLink><br /><searchLink fieldCode="AR" term="%22Johanna+Hautala%22">Johanna Hautala</searchLink><br /><searchLink fieldCode="AR" term="%22Anna-Kaisa+Tolonen%22">Anna-Kaisa Tolonen</searchLink><br /><searchLink fieldCode="AR" term="%22Taina+Välimaa%22">Taina Välimaa</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-4826-6401">0000-0002-4826-6401</externalLink>)<br /><searchLink fieldCode="AR" term="%22Sari+Kunnari%22">Sari Kunnari</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-5290-4851">0000-0001-5290-4851</externalLink>)
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+Speech%2C+Language%2C+and+Hearing+Research%22"><i>Journal of Speech, Language, and Hearing Research</i></searchLink>. 2025 68(2):808-826.
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  Data: American Speech-Language-Hearing Association. 2200 Research Blvd #250, Rockville, MD 20850. Tel: 301-296-5700; Fax: 301-296-8580; e-mail: slhr@asha.org; Web site: http://jslhr.pubs.asha.org
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  Data: Y
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  Data: 19
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  Data: 2025
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  Data: Journal Articles<br />Reports - Research
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  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Hard+of+Hearing%22">Hard of Hearing</searchLink><br /><searchLink fieldCode="DE" term="%22Deafness%22">Deafness</searchLink><br /><searchLink fieldCode="DE" term="%22Sensory+Aids%22">Sensory Aids</searchLink><br /><searchLink fieldCode="DE" term="%22Young+Children%22">Young Children</searchLink><br /><searchLink fieldCode="DE" term="%22Language+Usage%22">Language Usage</searchLink><br /><searchLink fieldCode="DE" term="%22Pragmatics%22">Pragmatics</searchLink><br /><searchLink fieldCode="DE" term="%22Interpersonal+Competence%22">Interpersonal Competence</searchLink><br /><searchLink fieldCode="DE" term="%22Demography%22">Demography</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+Ability%22">Cognitive Ability</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Language+Skills%22">Language Skills</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Finland%22">Finland</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1044/2024_JSLHR-23-00574
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1092-4388<br />1558-9102
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose: Children develop social-pragmatic understanding with the help of sensory, cognitive, and linguistic functions by interacting with other people. This study aimed to explore (a) associations between auditory, demographic, cognitive, and linguistic factors and social-pragmatic understanding in children who use bilateral hearing aids (BiHAs) or bilateral cochlear implants (BiCIs) and in typically hearing (TH) children and (b) the effect of the group (BiHA, BiCI, TH) on social-pragmatic understanding when the effects of demographic, cognitive, and linguistic factors are controlled for. Method: The Pragma test was used to assess social-pragmatic understanding in 119 six-year-old children: 25 children who use BiHAs, 29 who use BiCIs, and 65 TH children. The Pragma test is a standardized test that requires answering socially and contextually demanding questions with varying focuses and thus enables a comprehensive assessment of social-pragmatic understanding. Associations between auditory, demographic, cognitive, and linguistic factors and the Pragma test performance were analyzed. Between-groups differences in the Pragma test performance were analyzed while statistically controlling for the effects of factors that were associated with the Pragma test scores. Results: The BiHA users who had better unaided pure-tone average hearing thresholds had better social-pragmatic understanding. A higher level of maternal education and nonverbal intelligence were associated with a better social-pragmatic understanding in the BiHA and BiCI groups. Linguistic abilities correlated strongly with social-pragmatic understanding in all groups. The deaf and hard of hearing (DHH) groups differed from the TH children in social-pragmatic understanding even after the effects of maternal education, nonverbal intelligence, and linguistic skills were controlled for. Conclusions: Despite early diagnosis of hearing loss and intervention, many DHH children are still at risk for social-pragmatic difficulties. Several factors may associate with social-pragmatic understanding in DHH children, which highlights the importance of a wide-ranging, multidisciplinary assessment, and the planning of focused, assessment-based interventions.
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  Data: 2025
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