While reading is challenging for many deaf individuals, some become proficient readers. Little is known about the component processes that support reading comprehension in these individuals. Speech-based phonological knowledge is one of the strongest predictors of reading comprehension in hearing individuals, yet its role in deaf readers is controversial. This could reflect the highly varied language backgrounds among deaf readers as well as the difficulty of disentangling the relative contribution of phonological versus orthographic knowledge of spoken language, in our case ‘English,’ in this population. Here we assessed the impact of language experience on reading comprehension in deaf readers by recruiting oral deaf individuals, who use spoken English as their primary mode of communication, and deaf native signers of American Sign Language. First, to address the contribution of spoken English phonological knowledge in deaf readers, we present novel tasks that evaluate phonological versus orthographic knowledge. Second, the impact of this knowledge, as well as memory measures that rely differentially on phonological (serial recall) and semantic (free recall) processing, on reading comprehension was evaluated. The best predictor of reading comprehension differed as a function of language experience, with free recall being a better predictor in deaf native signers than in oral deaf. In contrast, the measures of English phonological knowledge, independent of orthographic knowledge, best predicted reading comprehension in oral deaf individuals. These results suggest successful reading strategies differ across deaf readers as a function of their language experience, and highlight a possible alternative route to literacy in deaf native signers.

Highlights:

1. Deaf individuals vary in their orthographic and phonological knowledge of English as a function of their language experience.

2. Reading comprehension was best predicted by different factors in oral deaf and deaf native signers.

3. Free recall memory (primacy effect) better predicted reading comprehension in deaf native signers as compared to oral deaf or hearing individuals.

4. Language experience should be taken into account when considering cognitive processes that mediate reading in deaf individuals.

Suboptimal listening conditions interfere with listeners’ on-line comprehension. A degraded source signal, noise that interferes with sound transmission, and/or listeners’ cognitive or linguistic limitations are examples of adverse listening conditions. Few studies have explored the interaction of these factors in pediatric populations. Yet, they represent an increasing challenge in educational settings. We will in the following report on our research and address the effect of adverse listening conditions pertaining to speakers’ voices, background noise, and children’s cognitive capacity on listening comprehension. Results from our studies clearly indicate that children risk underachieving both in formal assessments and in noisy class-rooms when an examiner or teacher speaks with a hoarse (dysphonic) voice. This seems particularly true when task complexity is low or when a child is approaching her/his limits of mastering a comprehension task.

The comprehension of spoken language has been characterized by a number of “local” theories that have focused on specific aspects of the task: models of word recognition, models of selective attention, accounts of thematic role assignment at the sentence level, and so forth. The ease of language understanding (ELU) model (Rönnberg et al., 2013) stands as one of the few attempts to offer a fully encompassing framework for language understanding. In this paper we discuss interactions between perceptual, linguistic, and cognitive factors in spoken language understanding. Central to our presentation is an examination of aspects of the ELU model that apply especially to spoken language comprehension in adult aging, where speed of processing, working memory capacity, and hearing acuity are often compromised. We discuss, in relation to the ELU model, conceptions of working memory and its capacity limitations, the use of linguistic context to aid in speech recognition and the importance of inhibitory control, and language comprehension at the sentence level. Throughout this paper we offer a constructive look at the ELU model; where it is strong and where there are gaps to be filled.

Auditory training (AT) helps compensate for degradation in the auditory signal. A series of three high-quality training studies are discussed, which include, (i) a randomized controlled trial (RCT) of phoneme discrimination in quiet that trained adults with mild hearing loss (n = 44), (ii) a repeated measures study that trained phoneme discrimination in noise in hearing aid (HA) users (n = 30), and (iii) a double-blind RCT that directly trained working memory (WM) in HA users (n = 57). AT resulted in generalized improvements in measures of self-reported hearing, competing speech, and complex cognitive tasks that all index executive functions. This suggests that for AT related benefits, the development of complex cognitive skills may be more important than the refinement of sensory processing. Furthermore, outcome measures should be sensitive to the functional benefits of AT. For WM training, lack of far-transfer to untrained outcomes suggests no generalized benefits to real-world listening abilities. We propose that combined auditory-cognitive training approaches, where cognitive enhancement is embedded within auditory tasks, are most likely to offer generalized benefits to the real-world listening abilities of adults with hearing loss.