Investigating hearing, speech perception and spoken language skills in primary school classrooms

The Problem Language is the foundation for learning most other skills. To learn from spoken language, children must understand speech, which requires both sensory (hearing) and cognitive (language) abilities. Understanding speech is a challenge for many children for multiple reasons, and the resulting impact on their learning is not fully recognised or understood. A typical primary school class will contain children with reduced access to auditory information. Many of these children will not have been identified: newborn hearing screening does not detect mild or transient hearing loss, and hearing screening at school entry is no longer routine. Previous research has been inconclusive about whether mild/transient hearing loss affects children's language development. However, teachers report that children with mild-to-moderate hearing loss find it challenging to listen in noisy environments. They also suggest that the impact of mild hearing loss on speech, language and literacy development is often underestimated. Recent estimates suggest one in fifteen children start school with language difficulties that are unexplained by other biomedical conditions (such as diagnosed deafness/hearing loss or autism spectrum disorder). Difficulties with speech perception (hearing and recognising speech sounds) are often proposed as a potential cause of difficulties with learning language. However, there is limited systematic evidence concerning the relationships between mild/transient hearing loss, speech processing (converting speech sounds into language), spoken language learning and educational outcomes, highlighting the need for objective investigation in the wider primary school population. Our Solution This project takes a large-scale approach to this problem: assessing the hearing and speech processing abilities of whole classes of children, rather than targeting those with pre-existing diagnoses. This will allow us to establish the prevalence and co-occurrence of mild/transient hearing loss and speech processing difficulties at scale; and to assess the longer-term impact of these conditions on language outcomes, literacy and educational attainment. It will go beyond traditional measures (e.g. vocabulary) to assess the speed with which they recognise words, which is essential for day-to-day conversations and accessing education. In addition, we will measure how much children benefit from seeing a speaker's lip movements when listening, and consider whether these benefits support language development. What we will do We propose to administer computerised tests of hearing and speech listening to whole classrooms of children (~2400 children overall). Children will complete these assessments during engaging science education sessions, using tablets and headphones. We will also measure children's language and reading skills (e.g. their vocabulary knowledge), other cognitive abilities (e.g. paying attention) and then follow these children over two school years to determine how hearing and spoken language skills relate to standardised classroom outcomes (e.g. phonics check scores). How this will help The proposed project will help us gain a better understanding of the prevalence and impact of mild/transient hearing loss on children's spoken language skills, including speed of word processing. Our findings will help determine the support needs of children at risk of hearing and language difficulties, with a view to impacting clinical and educational policies to support children to reach their maximum potential. During the project, participating children will directly benefit from our science education sessions. We will also provide teacher training and data to help the schools we visit to identify and support individuals with hearing or language difficulties.