Conversation and pragmatics in children who are hard-of-hearing: a scoping review.
Jenna Bongioletti, Maree Doble, Alison Purcell
PMID 38757199WHAT IT FOUND
Children who are hard-of-hearing often struggle with conversation and pragmatics even when their spoken language skills appear age-appropriate.
This scoping review found that these difficulties persist into adulthood without targeted intervention, affecting social and educational outcomes.
Key findings
01Improved spoken language skills do not automatically translate to improved conversational and pragmatic abilities; children may have age-appropriate language but still struggle with interaction.
02Conversation and pragmatic difficulties in children who are hard-of-hearing often mirror those seen in adults, suggesting these issues persist without specific intervention.
03The review identified both fixed factors (e.g., degree of hearing loss) and malleable factors (e.g., early intervention access, device use) associated with better conversational outcomes.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The included studies were rated as low-quality observational evidence. There was substantial heterogeneity in participant profiles, making it difficult to generalize findings. Inconsistent reporting on key variables like age at diagnosis and device use limited the ability to draw firm conclusions. The review did not include a quality appraisal for all studies, only a sample of 20%.
Declared interests
The authors declared no conflicts of interest and received no financial support for this research.
The easy way to misread this
Do not assume that a child with age-appropriate spoken language scores has no need for pragmatic intervention. The review indicates that conversational difficulties can persist independently of language proficiency and may lead to long-term social and educational challenges if not specifically addressed.