Abstract
Working with students who are deaf or hard of hearing (DHH) can raise questions about whether language and literacy delays and difficulties are related directly to late and limited access to spoken language, to co-occurring language learning disabilities (LLD), or to both. A new Test of Integrated Language and Literacy Skills, which incorporates 15 subtests for profiling oral and written language at sound/word and sentence/discourse levels, was used to assess 3 groups of school-age students (ages 6-18 years; n = 43 each). Students in 2 comparison groups-a typically developing (TD) group and an LLD group-were matched individually for age, sex, race/ethnicity, and parental education to 43 DHH students with moderate-to-profound bilateral sensorineural hearing loss. The DHH students used either cochlear implants (n = 28), if their hearing levels were profound, or hearing aids (n = 14), if their hearing levels were more moderate. All had been learning English primarily through listening and speaking from a young age. The DHH group performed poorer than the TD students in all areas except for the Written Expression discourse score. The DHH students performed poorer than the LLD students on Nonword Repetition and all other oral language subtests (except Vocabulary Awareness and Digit Span Backward) but did not differ from the LLD group on written language subtests (i.e., Nonword Reading; Reading Fluency; and Reading Comprehension and Written Expression discourse, sentence, and word measures). The only exception was represented by Nonword Spelling. Regression models showed that vocabulary awareness was the major predictor of DHH students' listening comprehension, reading comprehension, and nonword spelling skills. Phonemic awareness skills significantly contributed to their reading decoding. These results indicate the value of using comprehensive direct assessment to profile DHH students' oral and written language skills from subword to discourse levels.