The strengths and weaknesses in verbal short-term memory and visual working memory in children with hearing impairment and additional language learning difficulties Suzi Willis *, Juliet Goldbart, Jois Stansfield Health Professions Department, Speech Pathology & Therapy, Manchester Metropolitan University, Manchester, UK A R T I C L E I N F O Article history: Received 6 September 2013 Received in revised form 12 April 2014 Accepted 16 April 2014 Available online 26 April 2014 Keywords: Hearing-impaired Children Short-term memory Working memory Cochlear implants Language impairment A B S T R A C T Objectives: To compare verbal short-term memory and visual working memory abilities of six children with congenital hearing-impairment identified as having significant language learning difficulties with normative data from typically hearing children using standardized memory assessments. Methods: Six children with hearing loss aged 8–15 years were assessed on measures of verbal short-term memory (Non-word and word recall) and visual working memory annually over a two year period. All children had cognitive abilities within normal limits and used spoken language as the primary mode of communication. The language assessment scores at the beginning of the study revealed that all six participants exhibited delays of two years or more on standardized assessments of receptive and expressive vocabulary and spoken language. Results: The children with hearing-impairment scores were significantly higher on the non-word recall task than the “real” word recall task. They also exhibited significantly higher scores on visual working memory than those of the age-matched sample from the standardized memory assessment. Conclusions: Each of the six participants in this study displayed the same pattern of strengths and weaknesses in verbal short-term memory and visual working memory despite their very different chronological ages. The children’s poor ability to recall single syllable words in relation to non-words is a clinical indicator of their difficulties in verbal short-term memory. However, the children with hearing- impairment do not display generalized processing difficulties and indeed demonstrate strengths in visual working memory. The poor ability to recall words, in combination with difficulties with early word learning may be indicators of children with hearing-impairment who will struggle to develop spoken language equal to that of their normally hearing peers. This early identification has the potential to allow for target specific intervention that may remediate their difficulties. ã 2014 Elsevier Ireland Ltd. All rights reserved. Introduction There are between one and three children per 1000 live births each year in the UK who are diagnosed with permanent congenital hearing loss [1]. It is well known that hearing loss causes speech and language delays [2]. Digital hearing aids and cochlear implants (CI) have now made it possible for many children with severe and profound hearing loss to acquire age appropriate spoken language after initial, expected language delay of approximately three to four years [3,4]. Historically, research attributed the variability in spoken language outcomes for children using cochlear implants (CI) to factors such as age of implant, communication mode, and family support [3–9]. There is a proportion of children with hearing-impairment (HI) that exhibit delays in both receptive and expressive spoken language, even after several years of device use and intensive support from professionals and parents [10–13]. Even in ideal circumstances, of very early fitting of hearing aids or cochlear implants and the involvement of educated parents, there is a proportion of children with HI who still do not achieve spoken language commensurate with peers by the age of 4.5 years [12]. * Corresponding author at: Speech Pathology & Therapy, Elizabeth Gaskell Campus, Manchester Metropolitan University, Hathersage Road, Manchester M13 0JA, UK. Tel.: +44 01612474639. E-mail address: s.willis@mmu.ac.uk (S. Willis). http://dx.doi.org/10.1016/j.ijporl.2014.04.025 0165-5876/ ã 2014 Elsevier Ireland Ltd. All rights reserved. International Journal of Pediatric Otorhinolaryngology 78 (2014) 1107–1114 Contents lists available at ScienceDirect International Journal of Pediatric Otorhinolaryngology journal homepage: www.elsevier.com/locate/ijporl