Grant

Proposal
Garrido-Nag, Pick & Koo, 2013
1

The Neurodevelopmental Basis of Literacy Development in Deaf Children
Principal Investigator: Karen Garrido-Nag
Co-Investigator: Lawrence Pick
Co-Investigator: Daniel Koo

Background:
In the last 20 years, there has been a tremendous change in how children with hearing
loss are identified and educated. Newborn hearing screenings are now part of the standard
of care for most infants before they first leave the hospital. Approximately, 95% of all
newborns are screened (Joint Committee on Infant Hearing, 2007). Of these newborns,
61% who are identified with a hearing loss begin some kind of early
intervention (Centers for Disease Control and Prevention, 2006). In 2005 approximately
85% of these families chose spoken language options and amplification for their children
(Brown, 2006). With recent improvements in identification and technological advances in
amplification, there are better long-term prognoses related to speech, language and
literacy development of children with hearing loss (Spencer & Oleson, 2008). However,
there continues to be a significant lag in the development of these skills compared to
hearing peers, particularly in the area of preliteracy and literacy skills (Shaywitz, 2005).

Different factors have been investigated in attempts to identify the cause of the delay in
literacy skills. One such factor is the development of spoken language (English) skills.
Research has established key skills that occur during spoken language development (e.g.,
phonological awareness, knowledge of the alphabetic principle, and vocabulary
development) that are integral in achieving successful literacy development among
children with typical hearing (Shanahan, 2006). There is little research on these key
skills for young children who are deaf or hard of hearing.

Due to the biology of hearing loss, there is a breakdown in the access and use of spoken
language. This leads to a weak phonological representation in the brain (Skotara, Salden,
Kugow, Hanel-Faulhaber, Roder, 2012). Although phonological representations have
begun to be investigated in the deaf adult, there is a paucity of research in the developing
deaf child, especially as it relates to successful development of reading skills. At the
current time it is unclear the structure and function of the neural mechanisms underlying
phonological representations in deaf children using spoken language as their L1. This is
also true for young deaf children using American Sign Language as their L1. In bilingual
individuals, it has been reported that the L1 is used as a conduit for learning L2 and also
as a means of representing ideas and fostering critical thinking (Hagan, Carlson, Pollard-
Durodola, 2007). The use of L1 (ASL) to learn L2 (English) does not only foster learning
a second language but also increases proficiency in cognitive-linguistic skills necessary
for academic success.

The purpose of this study is to determine the relationship between the brains ability to
process phonological information, related cognitive functions, and the development of
literacy skills by examining deaf children before and after they are exposed to formal
education (i.e., Kindergarten to Second Grade). We also will examine which of the key
 Grant Proposal
Garrido-Nag, Pick & Koo, 2013
2

skills for reading development depends on early language experience. The present
study will compare deaf native signers and deaf non-native signers who have chosen
amplification and development of spoken language skills. We were specifically
interested in these grade levels as this is when children typically master reading and
writing skills. We want to explore the similarities and differences in children with typical
hearing, deaf children of parents whose primary language is ASL (natural language), and
deaf children who parents use spoken English (non-natural language).

Event-related Potentials (ERPs) will be used to provide an index of neural processes that
underlie phonological processing by children between the ages of 5 -7 years. ERP
measures, such as peak latency, amplitude, topography of components that index
phonological processing will be related to behavioral measures of speech, language, and
cognitive competence obtained at 5, 6, and 7 years of age in a longitudinal study.

The specific aims of the study are:

1. To determine the effect of input (natural vs. non-natural language) on the

development of phonological processes using brain and behavioral indices.
2. To determine what changes occur in the brain prior to exposure to formal
instruction and upon completion of formal instruction in reading.
3. To determine the nature and variability in growth of these skills over 3 school
years.
4. To determine what skills present at the age of 5 years that predict successful
development of literacy skills at 7 years of age.

The general hypotheses are:

1. We hypothesize that the development of overall cognitive-linguistic skills will be
influenced by input (natural L1 vs non-natural L1). In particular, children with a
strong L1 will show an overall better cognitive (global intelligence) and linguistic
(receptive language) development than children with limited L1.
2. We hypothesize that deaf children who consistently use their amplification and
have better satisfaction with their device will perform better on phonological tasks
that tap skills set necessary for reading development regardless of their L1 (ASL)
development.
3. We hypothesize that ERP measures will correlate with some behavioral measures
of phonological development (e.g. phonemic awareness, phoneme detection,
reading), as well as some other cognitive functions.

Research Design and Methods:

Overview: One experiment set will be performed over the course of 3 years. The goal of
this experiment set is to determine the relationship of phonological processing, as
indexed by ERPs, and cognitive, language and literacy abilities as indexed by behavioral
measures. The ERP task will be designed to tap phonological processing associated with
reading. Several different language and cognitive measures will be selected to examine
whether phonological processes are more closely related to certain variables than others.
 Grant Proposal
Garrido-Nag, Pick & Koo, 2013
3

Task: Each child will be administered a battery of tests (approximately 2 hours) prior to
the ERP task that will assess the following domains: Language Background
Questionnaire (parents), Language Background Questionnaire (Child), History of use of
amplification (consistency of use), History of intervention/education, Satisfaction
Questionnaire for parents (use of amplification), Satisfaction Questionnaire for children
(use of amplification), Global Intelligence , Receptive and Expressive Language Testing,
Language Sample (Phonological Production), Phonemic Awareness, Working Memory,
Reading, and Social-Emotional Development. Parents will be provided a brief summary
report of their childs performance written by a trained research assistant and supervised
by a licensed psychologist.

All children will participate in both the behavioral and electrophysiological experiments
at 5, 6, and 7 years of age. We expect some attrition across the time course of the study
but will make concerted efforts throughout the year to maintain contact and relationships
with the families before their next visits. There will be one session required for
completion of the experiment set at each age level.

Participants: The children used in this project will be drawn from the populations of the
Washington DC metro area, and recruited through advertisements, connections with local
community organizations and through Gallaudet University ties. Participants will have no
known neurological or psychiatric, conditions, and no history or family history of
learning or speech/language impairments. The study will consists of 3 groups: (1) 20
congenitally severely-profoundly deaf who have learned English as their L1 who
received amplification (hearing aid or cochlear implant) between the ages of 12-18
months and continue to use English as their primary language, (2) 20 congenitally
severely-profoundly deaf who have learned ASL from birth (L1) and learned English (l2)
after receiving amplification (hearing aid or cochlear implant) between the ages of 12-18
months, and (3) 20 hearing children matched for age, sex, SES, and educational
background of the family. All the children should have been born severely-profoundly
deaf and fitted with amplification between the ages of one to two years. Only children
whose parents have chosen an oral mode of communication for early intervention after
amplification will be included in the study. Written assent will be obtained from the
children. Oral assent will be obtained from younger children who are capable of giving
assent.

We will ask the parents to allow the children to come for three ERP sessions and three
behavioral sessions across the course of the study. These age groups have been chosen as
this is when literacy skills are taught.

Retention of Participants: We will send birthday cards, holiday cards and newsletters to
parents with a change of address postcards. We will also telephone parents before the
next session to remind them that we need to schedule an appointment. We will also
reschedule sessions within two weeks of cancellation.
 Grant Proposal
Garrido-Nag, Pick & Koo, 2013
4

Procedures: All ERP experiments will take place in a soundproof, electrically-shielded
booth. Behavioral experiments will take place in a quite room free of auditory and visual
distractions.

Preliminary Budget including anticipated resources, equipment, supplies, etc. (For

non-Gallaudet constituents please provide a brief description of your institutions policy
regarding federally negotiated overhead rate (indirect costs). If you have difficulty
obtaining this information, please submit your best estimate.
Projected Budget (3 Years)

Personel Year 1 Year 2 Year 3

Name Role on Project Type % Effort
Appt
Months)
Karen Garrido-Nag Principal Investigator 9 12 6480.00 6480.00 6480.00
3 50 9000.00 9000.00 9000.00

Lawrence H. Pick Co- Investigator 9 12 8520.00 8520.00 8520.00

3 20 4733.00 4733.00 4733.00

Daniel Koo Co-Investigator 3 20 4837.00 4837.00 4837.00

TBN Lab Manager 12 20 hours 15600.00 15600.00 15600.00

TBN RA 1 12 10 hours 7800.00 7800.00 7800.00

TBN RA 2 12 10 hours 7800.00 7800.00 7800.00

Subtotal Personnel Costs 64770.00 64770.00 64770.00

Compensation (60 x $100) 6000.00 6000.00 6000.00

Advertising 750.00 750.00 750.00
Subtotal Participant Compensation 6750.00 6750.00 6750.00

Tests Materials 4000.00 500.00 500.00

Subtotal Test Materials 4000.00 500.00 500.00

Technology and Service Contracts 3500.00 3500.00 3500.00

Subtotal Technology and Service Contracts 3500.00 3500.00 3500.00

Computer 2000.00 0.00 0.00

Printer 1000.00 1000.00 1000.00
Video 1000.00 1000.00 1000.00
Subtotal Equipment 4000.00 2000.00 2000.00

Lab Supplies 3000.00 3000.00 3000.00

Electrode Cap 6000.00 6000.00 6000.00
Subtotal Supplies 9000.00 9000.00 9000.00

Total Funding Requested 92020.00 90020.00 90020.00

 Grant Proposal
Garrido-Nag, Pick & Koo, 2013
5

Priorities to be addressed:
Priority Areas to be Addressed in the How does the proposed project address
Proposal this area?
problems that prevent the use of and benefit This project seeks to look at the
from hearing enhancement technologies relationship of access to spoken language
through use of amplification and the
development of literacy skills.
problems that reduce the use and benefit of This project will look at consistency of use
hearing enhancement technologies and satisfaction with chosen amplification
as it relates to cognitive-linguistic
development
technological factors that prevent or reduce
adoption of hearing enhancement devices
technological factors that prevent or reduce
benefit from hearing enhancement devices
improve the compatibility of hearing
enhancement technologies with other
technologies such as cell phones, mobile
devices, television, and the Internet
improve the performance of hearing
enhancement devices in social
environments
enhance aural rehabilitation to maximize This project will attempt to identify factors
hearing enhancement in real-life settings that can enhance or reduce success in aural
rehabilitation for young children
enhance consumer involvement strategies
(e.g., online access to peer and expert input
on hearing technologies and
communication strategies; consumer focus
groups and surveys; and consumer beta
testing and review of products) to
maximize hearing enhancement in real-life
settings
involve key stakeholders (including but not
limited to people with hearing loss) in the
design and implementation of RERC
activities