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Language Skills and Nonverbal Cognitive Processes Associated
Language Skills and Nonverbal Cognitive Processes Associated
A R T I C L E I N F O A B S T R A C T
Article history: The main aim of this study was to examine the relationship between language skills
Received 17 July 2014 (vocabulary knowledge and phonological awareness), nonverbal cognitive processes
Accepted 21 August 2014 (attention, memory and executive functions) and reading comprehension in deaf children.
Available online 18 September 2014
Participants were thirty prelingually deaf children (10.7 1.6 years old; 18 boys, 12 girls),
who were classified as either good readers or poor readers by their scores on two reading
Keywords:
comprehension tasks. The children were administered a rhyme judgment task and seven
Cognitive processes
computerized neuropsychological tasks specifically designed and adapted for deaf children to
Deaf children
Reading comprehension evaluate vocabulary knowledge, attention, memory and executive functions in deaf children.
A correlational approach was also used to assess the association between variables. Although
the two groups did not show differences in phonological awareness, good readers showed
better vocabulary and performed significantly better than poor readers on attention, memory
and executive functions measures. Significant correlations were found between better scores
in reading comprehension and better scores on tasks of vocabulary and non-verbal cognitive
processes. The results suggest that in deaf children, vocabulary knowledge and nonverbal
cognitive processes such as selective attention, visuo-spatial memory, abstract reasoning and
sequential processing may be especially relevant for the development of reading
comprehension.
ß 2014 Elsevier Ltd. All rights reserved.
1. Introduction
Learning how to read is one of the most important tasks deaf children have to face. Since our society transmits the
majority of information in an oral way, good reading skills are a very efficient mean of receiving and acceding information for
deaf individuals. However, there is considerable evidence, both in English-speaking and in Spanish-speaking populations,
that deaf children do not attain the same reading levels as hearing children (e.g. Allinder & Eccarius, 1999; Conrad, 1979;
Lissi, Raglianti, Grau, Salinas, & Cabrera, 2003; Torres & Santana, 2005; Traxler, 2000; Wauters, Van Bon, & Tellings, 2006).
Some authors such as Shankweiler, Liberman, Mark, Fowler, and Fischer (1979) and Perfetti and Sandak (2000), have
hypothesized that these low reading levels in many deaf children are due to the fact that deafness prevents access to spoken
language, resulting in deficiencies in phonological processing (mainly deficits in awareness of phonological and phonetic
* Corresponding author at: Department of Psychology, University of Almerı́a, Ctra. Sacramento s/n, Almerı́a 04120, Spain. Tel.: +34 950214623;
fax: +34 950214383.
E-mail address: tdaza@ual.es (M.T. Daza).
http://dx.doi.org/10.1016/j.ridd.2014.08.030
0891-4222/ß 2014 Elsevier Ltd. All rights reserved.
M.T. Daza et al. / Research in Developmental Disabilities 35 (2014) 3526–3533 3527
recoding in lexical access). However, this hypothesis has been challenged by other researchers who have demonstrated that
some deaf individuals can use phonological encoding (e.g. Hanson, Goodell, & Perfetti, 1991; Kelly, 1993; LaSasso, Crain, &
Leybaert, 2003; Leybaert & Alegria, 1993).
Phonological skills have shown to be a strong predictor of reading ability in young hearing children (e.g. Carroll, Snowling,
Hulme, & Stevenson, 2003; Castles & Coltheart, 2004; Parrila, Kirby, & McQuarrie, 2004; Wagner & Torgesen, 1987).
However, in deaf children this relationship is not so clear. Although much of the previous research on predictors of reading
success in deaf children has focused on analyzing the relationship between phonological awareness (ability to detect and
manipulate the constitute sounds of words) and reading ability, the results of these studies are contradictory. For example,
Mayberry, del Giudice, and Lieberman (2011) conducted a meta-analysis of 58 studies which examined the relationship
between phonological awareness and reading ability in deaf children. The results showed that half of all studies reviewed
found a significant relationship between phonological awareness and reading skills, but the remaining half did not.
In other studies it has been found that other language skills such as vocabulary knowledge are also related to reading
achievement in deaf children (e.g. Kyle & Harris, 2010; LaSasso & Davey, 1987; Waters & Doehring, 1990). Kyle and Harris
(2010) suggested that different linguistic (i.e. phonological processing vs. vocabulary knowledge) skills could be important
for different components of reading ability (i.e. word decoding vs. reading comprehension). In support of this view Kyle and
Harris (2010) in a longitudinal study found that linguistic skills such as vocabulary knowledge and speechreading were
associated with reading isolated words. Yet only vocabulary knowledge showed to be a good predictor of success on sentence
and text comprehension.
Moreover, the development of reading skills is a complex process (especially reading comprehension), which also
involves nonverbal cognitive processes (e.g. Rosselli, Matute, & Ardila, 2006; Share & Stanovich, 1995). However, researchers
have not paid much attention to the relationship between these nonverbal cognitive processes and reading comprehension
skills in deaf children. Therefore, our knowledge concerning the role of attention, memory and executive functions in the
reading achievement of deaf children is more limited.
The main aim of this study was to identify language skills and nonverbal cognitive processes associated with reading
comprehension in deaf children. To this end, a group of 30 deaf children between 8 and 16 years of age were classified as
either good readers or poor readers by their scores on two reading comprehension tasks. Grouping by these criteria yielded
15 children in the poor readers group (10 boys and 5 girls) and 15 children in the good readers group (8 boys and 7 girls). In
order to assess the relation between reading comprehension and phonological awareness, we tested the two groups of deaf
children (good vs. poor readers) on a rhyme judgment task requiring picture selection (e.g. Kay, Lesser, & Coltheart, 1992) as
an index of phonological awareness. Then, both groups were administered seven computerized neuropsychological tasks
specifically designed and adapted for deaf children, to measure vocabulary knowledge and nonverbal cognitive processes
such as selective attention, visuospatial working memory and components of executive functioning like nonverbal abstract
reasoning and sequential processing (Daza, Guil, López-López, Salmerón-Romero, & Garcı́a-Giménez, 2011).
If phonological awareness is not a strong predictor of success in reading comprehension in deaf children, we would expect
to find that good and poor readers show similar performance on the phonological awareness task. However, if vocabulary
knowledge and the nonverbal cognitive processes mentioned above are related to success in reading comprehension, we
should expect to find differences between good and poor readers in the remaining tasks.
2. Method
2.1. Participants
A total of thirty deaf children (18 boys and 12 girls) between 8 and 16 years of age (mean age 10.7 1.6 years) participated
in this study. All children were prelingually deaf (with a hearing loss onset diagnosed prior to age 2), and 29/30 were children of
hearing parents. Of all children, 25/30 had severe or profound hearing loss whereas only 5/30 had mild to moderate hearing loss.
More than half had a congenital hearing loss. Most deaf children (23/30) preferably used spoken Spanish to communicate (the
remaining 7/30 used Spanish Sign Language; SSL). Of all children, 50% had cochlear implants and the remaining 50% conventional
hearing aids.
All participants were right-handed and had no history of neurological disorder. Participants were recruited from public
schools and associations for deaf children. They were enrolled in a larger study, in the south of Spain, on reading problems in
deaf children. Children were tested at their schools or associations, and parents or tutors provided a written informed
consent prior to testing.
On the basis of the participants’ scores on two computerized reading comprehension tasks, they were classified as either
good readers or poor readers. The reading comprehension tasks used were a sentence-picture matching task and a sentence
completion task. The sentence-picture matching task (modified from the Assessment Battery of Reading Processes, or
PROLEC-R; Cuetos, Rodrı́guez, Ruano, & Arribas, 2006), examined syntactic processing. The task contained 16 sentences (for a
maximum score of 16): 4 active, 4 passive, 4 object focus and 4 relative subordinates. Children were instructed to read the
sentence (either silently or overtly in their preferred communication mode) and then to choose the one picture out of four
which was most consistent with the meaning of the sentence. All sentences were reversible, since the subject and object of
the action were interchangeable.
3528 M.T. Daza et al. / Research in Developmental Disabilities 35 (2014) 3526–3533
The sentence completion task was a computerized version of the task developed by Soriano, Pérez, and Domı́nguez
(2006). The task contained 60 sentences (maximum score = 60), each of which had a missing word. In each trial children had
to read a sentence and choose the missing word from a selection of four words (the target and three semantic distracters). In
all sentences, choosing the correct word required not only access to the meaning of words but also recognition of the
relationships established between them. If participants are limited to performing only semantic processing of the words,
they will commit errors that lead them to choose one of the semantic distractors.
We computed a global score for each participant by averaging scores for the two tasks. With these global scores we then
computed the sample median (M = 12). Those subjects whose global score was above the sample median were assigned to
the good readers group, and those subjects whose global score was below the sample median were assigned to the poor
readers group. Grouping by these criteria yielded 15 children in the poor reader group (10 boys and 5 girls) and 15 children in
the good reader group (8 boys and 7 girls).
(6) Concepts. A computerized version of the Concepts subtest, extracted from the Wechsler Intelligence Scale for
Children-IV (Wechsler, 1974). This task was designed to measure non-verbal reasoning and concept formation. In each trial
children are shown 2 or 3 rows containing different objects, and instructed to select objects (one from each row) that go
together based on an underlying concept. The maximum score is 23.
(7) Motoric Alternation. This is based on the Hand Movements subtest of the K-ABC (Kaufman & Kaufman, 1983). This is
a sequential processing task which provides information about skills for solving problems whose elements are presented to
them sequentially, in which each visual-motoric stimulus is related, temporally and linearly, with the preceding one. In each
trial children have to copy a series of taps the examiner makes on the table with the fist, palm or side of the hand. The
maximum score is 21.
Data were examined to determine whether they fit a normal distribution. First, good and bad readers were compared on
socio-demographic and clinical characteristics using Student’s t-test, Mann–Whitney U-test, Chi-square or Fisher’s exact
test, as appropriate. Then, comparison tests for independent samples were carried out to compare phonological awareness,
vocabulary knowledge and nonverbal cognitive measures. Appropriate measures of effect size for the t-test (Cohen’s d) and
for the Mann–Whitney U-test were included. Correlations were conducted between reading comprehension and vocabulary,
attention, memory and executive functions measures. When a significant difference was found between good and bad
readers in any of the socio-demographic and clinical variables, it was included as a covariate in the correlation analysis.
3. Results
The good and bad reader groups did not differ significantly in gender, age, degree of hearing loss, cause of deafness and
cochlear implant use. The two groups differed only in preferred communication mode (see Table 1).
As we expected, both groups showed similar phonological awareness, since in the rhyme judgment task good and poor
readers showed a similar percentage of correct responses (t = .697; p = .49; see Fig. 1). Correlation analysis between the
average score in reading comprehension tasks and the percentage of correct responses in the rhyme judgment task,
confirmed that there was no relationship between the two measures.
However, with the measures of vocabulary, spatial attention (Cancellation Forms task), visuospatial short-term and
working memory (Visuospatial Memory Spam, Spatial Memory and Memory of Faces tasks) and executive functions
(Concepts and Motoric Alternation tasks), deaf children in the good readers group showed significantly better performance
than those deaf children in the group of poor readers (see Table 2).
After including preferred communication mode as covariate, significant partial correlations were established between
average score in reading comprehension tasks and score on Vocabulary (r = .56; p = .003), hits on Cancellation Forms (r = .47;
p = .014), scores on Visuospatial Memory Spam (direct order: r = .63; p < .001; indirect order: r = .66; p < .001), score on
Memory of Faces (r = .35; p = .06), score on Concepts (r = .46; p = .01) and score on Motoric Alternation (r = .60; p = .001).
These findings are consistent with the hypothesis that vocabulary knowledge and nonverbal cognitive processes are
related to reading ability in the deaf, and suggest that these measures specifically warrant further investigation in order to
determine a causal relation with reading success in the deaf.
Table 1
Characteristics and performance on the reading comprehension tasks of good and bad readers.
Gender (n)
Boys 8 10 x2 = .139 .709
Girls 7 5
Age (mean; SD) 11.13 (1.9) 10.27 (1.2) U = 86.0 .259
Degree of hearing loss (n)
Mild-moderate 3 2 Fisher’s exact test 1.0
Severe-profound 12 13
Cause of deafness (n)
Congenital 9 8 x2 = .000 1.0
Acquired-unspecified 6 7
Cochlear implant user (n)
Cochlear implant 7 8 x2 = .000 1.0
Conventional hearing aid 8 7
Preferred communication mode (n)
Spoken Spanish 15 8 Fisher’s exact test .006
Spanish Sign Language 0 7
Sentence-picture matching task (mean; SD) 9.87 (3.50) 6.27 (1.90) U = 40.50 .005 .51
Sentence completion task (mean; SD) 39.80 (14.77) 10.93 (2.91) t = 7.42 .000 .80 (d = 2.71)
3530 M.T. Daza et al. / Research in Developmental Disabilities 35 (2014) 3526–3533
Table 2
Mean scores (and standard deviations) obtained in the neuropsychological tasks by good and bad readers and group comparisons.
100
Percentage of correct responses
75
50
25
0
Good Readers Poor Readers
Fig. 1. Results obtained in the rhyme judgment task by good readers and poor readers.
4. Discussion
In the present study we examined the relation between linguistic and non-linguistic skills and reading success of deaf
children in tasks which require not just decoding individual words but also understanding the meanings of phrases.
To the best of our knowledge, this is the first study in which language skills (phonological awareness and vocabulary
knowledge) and nonverbal cognitive processes (selective attention, visuospatial working memory and components of
executive functioning), are studied in deaf children who show different performance on reading comprehension tasks (good
readers vs. bad readers).
The present sample yielded two groups that differed significantly in reading comprehension achievement, but not in
gender, age, degree of hearing loss, cause of deafness and cochlear implant use. With regard to the communication mode
preferably used by the deaf children between reading groups, there was a significant difference: the good readers all
preferred spoken language, while in the poor readers half of the children (7 of 15) preferred sign language. This result could
lead one to think that deaf children in the group of good readers had better phonological skills than deaf children in the bad
readers group; however the results of the rhyme judgment task did not support this hypothesis. In the rhyme judgment task,
before the children had to decide whether the names of the two pictures rhymed, they were asked if knew the names of these
objects. Although the good readers knew more objects names than the poor readers (a result consistent with the greater
vocabulary knowledge shown by the good readers) the good readers did not show a greater ability to detect object names
that rhymed. This result suggests that, as we expected, the differences in reading comprehension achievement shown by
both good and bad readers does not seem to be related to differences in their phonological awareness skills. Our results are
consistent with previous studies suggesting that in deaf children phonological skills do not seem to be strong predictors of
successful reading, especially when the specific reading component under investigation is reading comprehension (e.g. Kyle
& Harris, 2010).
Good and poor readers showed significant differences in vocabulary knowledge, suggesting that vocabulary knowledge
can be a good predictor of success in reading comprehension, as has been observed with hearing children (e.g. Cutting &
Scarborough, 2006; Dickinson, McCabe, Anastasopoulos, Peisner-Feinberg, & Poe, 2003). Kyle and Harris (2010) also found
that in a sample of deaf children, out of their reported measures, ‘‘only vocabulary knowledge was longitudinally related to
reading words and sentences and texts comprehension’’ (p. 240). Together these findings point to vocabulary development
as a point of focused intervention for reading in deaf children.
The present study showed that other nonverbal skills related to cognitive processes such as attention, memory and
executive functions may be especially relevant for the development of reading comprehension in deaf children. In the visual
M.T. Daza et al. / Research in Developmental Disabilities 35 (2014) 3526–3533 3531
selective attention task, poor readers showed more difficulties to selectively attend to and identify the target stimulus
among distractors, suggesting that this selective visual attention mechanism may play an important role in reading
comprehension performance in the deaf. According to the attention network model developed by Posner and collaborators
(e.g. Posner & Petersen, 1990; Posner & Rothbart, 2007; Posner, Sheese, Odludas, & Tang, 2006) the visual attention system
consists of at least three anatomically and functionally dissociable networks: orienting, alerting and executive control. In
terms of this model our results with the Cancellation Forms task suggests that reading comprehension achievement in deaf
children could be related to the proper functioning of the orienting network. This attention network has been associated with
areas of the parietal lobe and subcortical areas (for review, see Corbetta & Shulman, 2002), and is responsible for the
movement of attention through space, allowing the selection of specific and relevant information to the task we are
performing. In a recent study Daza and Phillips-Silver (2013) have found that early auditory deprivation has specific and
distinct effects on the development of each of these attention networks. Therefore, future studies will need to explore how
the development of the attention networks could influence the acquisition of literacy skills in deaf children.
Recently Ihnen, Petersen, and Schalaggar (2013) have noted that the relationship between attention and reading ability in
hearing children is attracting interest among researchers, because in clinical practice the comorbidity of dyslexia and ADHD
is highly prevalent. Additionally, several studies have shown deficits in visual attention on the basis of developmental
dyslexia (e.g. Gabrieli & Norton, 2012; Goldfarb & Shaul, 2013; Valdois, Bosse, & Tainturier, 2004; Vidyasagar & Pammer,
2010). However, with deaf children, studies about the role of visual attention in the acquisition of reading skills are scarce.
The present results obtained with memory tasks suggest that the ability to temporarily store non-verbal visual
information in short-term or working memory is also associated with the performance of deaf children in reading
comprehension. According to the authors of a widely accepted memory model (Baddeley, 1986, 1996, 2000; Baddeley,
Gathercole, & Papagno, 1998; Baddeley & Hitch, 1974; Baddeley & Logie, 1999) ‘‘working memory refers to the capacity-
limited ability to maintain and manipulate information relevant to an ongoing task’’. Working memory can be split into
four components: a phonological loop, a visuospatial sketchpad, an episodic buffer and a central executive component. The
phonological loop component is responsible for maintaining and manipulating verbal information (phonologically
encoded information), and the visuospatial component (sketchpad), is responsible for maintaining and manipulating
visual and/or spatial information (information encoded in the form of visual images). The episodic buffer is a multimodal
component which is capable of binding information from the phonological loop and visuospatial sketchpad components
and from long-term memory (Baddeley, 2000). The central executive is the main working memory component. It is
responsible for controlled processing in working memory, and it is considered to play various executive functions (for a
review, see Baddeley & Logie, 1999). Although the phonological component has been associated with reading ability in
hearing children (e.g. Alloway & Alloway, 2010; Cain & Oakhill, 2007), and with development of spoken language in deaf
children after cochlear implants (e.g. Geers, Brenner, & Davidson, 2003; Pisoni, Kronenberger, Roman, & Geers, 2011), our
results suggest that the visuospatial component of the working memory is also associated with reading comprehension in
the deaf children.
In our study, the good readers showed a stronger ability to process and temporarily maintain visuospatial information,
since they obtained significantly higher scores on visuospatial memory span, spatial memory and memory of faces tasks. The
information used in these tasks (spatial locations and unfamiliar faces) cannot be encoded verbally, so it requires the
involvement of the visuospatial working memory component. In addition, in the visuospatial memory span task, the good
readers showed not only broader span than poor readers (higher scores on direct order block), but also better ability to
manipulate visuospatial information in the working memory (higher scores on the indirect order block).
In previous studies on working memory in deaf and hearing children, deficits have been found with verbal information
(digits, words written or nameable pictures), in deaf children (e.g. Campbell & Wright, 1990; Hanson, 1982; Krakow &
Hanson, 1985). However, with visual or spatial information (spatial locations, unfamiliar faces or unnameable symbols), deaf
and hearing children have shown similar performance in working memory tasks (e.g. López-Crespo, Daza, & Méndez-López,
2012; Tomlinson-Keasey & Smith-Winberry, 1990). Therefore, it is not yet known whether in deaf children the visuospatial
encoding in working memory could compensate for deficits in verbal or phonological working memory. In others words, it is
necessary to further explore whether verbal information that hearing children can maintain and manipulate based on a
phonological code (speech-based code) could be processed by deaf children in a ‘‘multimodal-based code’’. In this sense, it is
also necessary to remember that many investigators have been advocating the idea that deaf children’s speech-based code
(phonological representation) does not depend exclusively on auditory information, but is based on non-auditory
multimodal aspects such as, lip-reading, information derived from orthography and kinesthetic feedback associated with
fingerspelling and speech movements (e.g. Alegrı́a, Leybaert, Charlier, & Hage, 1992; Bellugi, Klima, & Siple, 1975;
Haptonstall-Nykaza & Schick, 2007; Harris & Moreno, 2006; Leybaert, 1993; MacSweeney, 1998; Poizner, Bellugi, & Tweney,
1981). Future studies will have to explore the functioning of the multimodal working memory component (episodic buffer)
in deaf children, and their role in learning to read.
Finally, in executive functions (concepts and motoric alternation tasks), we also found significant differences between
good and poor readers, suggesting that executive components involved in these tasks could be good predictors of reading
success in deaf children. Thus, in the task of non-verbal reasoning and concept formation (concepts), significant capacity for
reflection and self-control are also required. Children have to select objects that go together based on an underlying concept,
discarding erroneous possibilities and inhibiting impulsive responses. In other words, good performance in this task also
requires retrieving information from long-term memory, monitoring information held in working memory, suppression of
3532 M.T. Daza et al. / Research in Developmental Disabilities 35 (2014) 3526–3533
irrelevant information and inhibition of impulsive responses. In hearing children, recent studies have also found that the
executive component related to the mechanism of suppression is associated with reading achievement (e.g. Cutting,
Materek, Cole, Levine, & Mahone, 2009; Sesma, Mahone, Levine, Eason, & Cutting, 2009). Similarly, the motoric alternation
task requires cognitive planning, another executive component associated with reading achievement in hearing children
(e.g. Gernsbachen, 2006; Redick, Heitz, & Engle, 2007).
In conclusion, our results are consistent with the hypothesis that deaf children, though they do not show good
phonological skills, can reach good levels of reading through an alternative route not based on spoken language (e.g. Koo,
Crain, LaSasso, & Eden, 2008). Non-verbal cognitive processes such as visuospatial attention, visuospatial working memory
and executive functions may play an important role in this alternative reading route. We believe that the results of this study
not only contribute to a better understanding of how deaf children acquire literacy skills, but also can be transferred to the
educational environment with educational programs which considered training of these nonverbal cognitive processes.
Acknowledgments
This research was supported by FEDER-Consejerı́a de Economı́a, Innovación y Ciencia (JuntadeAndalucı́a) grant P07-SEJ-
3412, to Marı́a Teresa Daza González. The authors thank the Rosa Relaño (Almerı́a, Spain) and Santa Marı́a de Gracia (Murcia,
Spain) public schools and the ASPANPAL (Murcia, Spain) and APANDA (Cartagena, Spain) deaf parents’ associations for their
kind collaboration in this research, and Nayalı́ Garcı́a Giménez (University of Almerı́a), who provided assistance in the
collection of data.
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