Feasibility of a Supplemental Phonological Awareness Intervention via Telepractice for Children with Hearing Loss: A Preliminary Study

  • Sue Ann S. Lee Texas Tech University Health Sciences Center
  • Brittany Hall Texas Tech University Health Sciences Center
  • Sherry Sancibrian Texas Tech University Health Sciences Center


The goal of the current study was to examine the feasibility of a telepractice intervention to improve phonological awareness skills in children with hearing loss as compared to a conventional in-person intervention.  Twenty children with hearing loss participated in this study. Two groups of ten children each received a supplemental phonological awareness intervention either via telepractice or an in-person service delivery model. Within each of the two groups, five children were enrolled in preschool or kindergarten and five children were enrolled in first or second grade. The two groups of children demonstrated similar phonological awareness, non-verbal IQ, and vocabulary skills during pre-tests.  After a 12-week intervention children with hearing loss showed improved phonological awareness skills as measured by a standardized post-test. No significant differences were found between the performance of the telepractice group and in-person group. Nor was a significant interaction found between the two age groups (PreK/K vs. 1st /2nd grade) and the two types of service delivery models (in-person vs. telepractice). The results suggest that a telepractice service delivery model is feasible for young children with hearing loss, and that telepractice may be as effective as in-person intervention in improving phonological awareness skills.



Author Biographies

Sue Ann S. Lee, Texas Tech University Health Sciences Center

Sue Ann Lee, PhD, CCC-SLP

Associate Professor

Department of Speech-Language-Hearing Sciences

Texas Tech University Health Sciences Center

Lubbock TX 79430

Brittany Hall, Texas Tech University Health Sciences Center
Assistant professor
Sherry Sancibrian, Texas Tech University Health Sciences Center
University distinguished professor


American Speech-Language-Hearing Association. (2005). Speech-language pathologists providing clinical services via telepractice: position statement [position statement].

Retrieved from http://www.asha.org/docs/html/PS2005-00116.html

Aram, D., Most, T., & Mayafit, H. (2006). Contributions of mother-child storybook telling and joint writing to literacy development in kindergartners with hearing loss. Language, Speech, and Hearing Services in Schools, 37, 209-223.

Brady, S., Fowler, A., Stone, B., & Winbury, N. (1994). Training phonological awareness: A study with inner-city kindergarten children. Annals of Dyslexia, 44, 26-59.

Brennan, F., & Ireson, J. (1997). Training phonological awareness: A study to evaluate the effects of a program of metalinguistic games in kindergarten. Reading and Writing: An

Interdisciplinary Journal, 9, 241-263.

Brownwell, R. (2010). Receptive One-word Picture Vocabulary Test (4th ed.). The Psychological Corporation.

Burgemeister, B., Blum, L.H., & Lorge, I. (1972). Columbia Mental Maturity Scale. The Psychological Corporation.

Cary, L., & Verhaeghe, A. (1994). Promoting phonemic analysis ability among kindergartners: Effects of different training programs. Reading and Writing, 6, 251-278.

Cohn, E.R., & Cason, J. (2012). Telepractice: A wide-angle view for persons with hearing loss. Volta Review, 112, 207-226.

Coleman, J. J., Frymark, T., Franceschini, N.M., & Theodoros, D. G. (2015). Assessment and treatment of cognition and communication skills in adults with acquired brain injury via

telepractice: A systematic review. American Journal of Speech-Language Pathology, 24, 295-315.

Colin, S., Magnan, A., Ecalle, J., & Leybaert, J. (2007). Relation between deaf children’s phonological skills in kindergarten and word recognition performance in first grade. Journal of Child Psychology & Psychiatry, 48, 139-146. doi: 10.1111/j.1469-7610.2006.01700.x.

Constantinescu, G., Waite, M., Dornan, D., Rushbrooke, E., Brown, J., McGovern, J., Ryan, M., & Hill, A. (2014). A pilot study of telepractice delivery for teaching listening and spoken

language to children with hearing loss. Journal of Telemedicine and Telecare, 20, 135-140.

Cunningham, A.E. (1990). Explicit versus implicit instruction in phonemic awareness. Journal of Experimental Child Psychology, 50, 429-444.

Dillon, C.M., de Jong, K., & Pisoni, D.B. (2012). Phonological awareness, reading skills, and vocabulary knowledge in children who use cochlear implants. Journal of Deaf

Studies and Deaf Education, 17, 205-226.

Edwards, M., Stredler-Brown, A., & Houston, K.T. (2010). Expanding use of telepractice in speech-language pathology and audiology. Volta Review, 112, 227-242.

Ekeland, A. G., Bowes, A., & Flottorp, S. (2010). Effectiveness of telemedicine: A systematic review of reviews. International Journal of Medical Informatics, 79, 736-771.

Engelmann, S., Haddox, P., & Bruner, E. (1983). Teach your child to read in 100 easy lessons. New York: Simon & Schuster.

Entwisle, L.K., Brouwer, K., Hanson, E., & Messersmith, J. (2016). A systematic review of emergent literacy interventions for preschool-age children with cochlear implants. Contemporary Issues in Communication Science and Disorders, 43, 64-76.

Gabel, T., Grogan-Johnson, S., Alvares, R., Bechstein, L., Taylor, J. (2013). A field study of telepractice for school intervention using the ASHA NOMS K-12 Database. Communication Disorders Quarterly, 35, 44-53.

Geers, A.E., & Hayes, H. (2011). Reading, writing, and phonological processing skills of adolescents with 10 or more years of cochlear implant experience. Ear & Hearing, 32, 49S-59S.

Gillon, G. T. (2004). Phonological awareness: From research to practice. New York: The Guilford Press.

Gillon, G.T. (2008). The Gillon Phonological awareness training programme: An intervention programme for children at risk for reading disorder. Available at http://www.education.canterbury.ac.nz/people/gillon/programme%20booklet%20%202008.pdf

Grogan-Johnson, S., Alvares, R., Rowan, L., & Creaghead, N. (2010). A pilot study comparing the effectiveness of speech language therapy provided by telemedicine with conventional

on-site therapy. Journal of Telemedicine and Telecare, 16, 134-139.

Grogan-Johnson, S., Gabel, R. M., Taylor, J., Rowan, L. E., Alvares, R., & Schenker, J. (2011). A pilot exploration of speech sound disorder intervention delivered by telehealth to

school-age children. International Journal of Telerehabilitation, 3, 31-42.

Grogan-Johnson, S., Schmidt, A. M., Schenker, J., Alvares, R., Rowan, L. E., & Taylor, J. (2013). A comparison of speech sound intervention delivered by telepractice and side-

by-side service delivery models. Communication Disorders Quarterly, 34, 210-220.

Hatcher, P.J., Hulme, C., & Ellis, A.W. (1994). Ameliorating early reading failure by integrating the teaching of reading and phonological skills: The phonological linkage hypothesis. Child Development, 65, 41-57.

Houston,K.T., & Bradham, T.S. (2011). Parent engagement in audiologic habilitation: Increasing positive outcomes for children with hearing loss. ASHA Leader, 16(8), 5-6.

Houston, K.T., Munoz, K.F., & Bradham, T. S., (2011). Professional development: Are we meeting the needs of state EHDI programs? Volta Review, 111, 209-223.

Houston, K.T., & Stredler-Brown, A. (2012). Expanding use of telepractice in speech-language pathology and audiology. Volta Review, 112, 227-242.

James, D., Rajput, K., Brinton, J., & Goswami, U. (2008). Phonological awareness, vocabulary, and word reading in children who use cochlear implants: Does age of

implantation explain individual variability in performance outcomes and growth? Journal of Deaf Studies and Deaf Education, 13, 117-137.

Joint Committee on Infant Hearing. (2007). Year 2007 position statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics, 120, 898-921.

Kyle, F., & Harris, M. (2011). Longitudinal patterns of emerging literacy in beginning deaf and hearing readers. Journal of Deaf Studies and Deaf Education, 16, 289-304

Krose. J., Lotz, W., Puffer, C., & Osberger, M.J. (1986). Language and learning skills of hearing impaired children. ASHA Monographs, 23, 66-77.

Ling, D. (1976). Speech and the hearing-impaired child: Theory and practice. Washington, DC: Alexander Graham Bell Association for the Deaf.

Ling, D. (1989). Foundations of spoken language for the hearing-impaired child. Washington, DC: Alexander Graham Bell Association for the Deaf.

Lundberg, I., Frost, J., & Petersen, O. (1988). Effects of an extensive program for stimulating phonological awareness in preschool children. Reading Research Quarterly, 23, 263-285.

Mashima, P.A., & Doarn, C. R., (2008). Overview of telehealth activities in speech-language pathology. Telemedicine and e-Health, 14, 1101-1117.

Miller, P. (1997). The effect of communication mode on the development of phonological awareness in prelingually deaf students. Journal of Speech, Language, and HearingResearch, 40, 1151-1163.

Miller, E.M., Lederberg, A.R., Easterbrooks, S.R. (2013). Phonological awareness: Explicit instruction for young deaf and hard-of-hearing children. Journal of Deaf Studies and Deaf Education, 18, 206-227.

Moeller, M.P., Tomblin, J.B., Yoshinaga-Itano, C., Connor, C., & Jerger, S. (2007). Current state of knowledge: Language and literacy of children with hearing impairment. Ear & Hearing, 28, 740-753.

Most, T., Aram, D., & Andorn, T. (2006). Early literacy in children with hearing loss: A comparison between two educational systems. Volta Review, 106, 5-28.

Narr, R. F. (2008). Phonological awareness and decoding in deaf/hard-of-hearing students who use Visual Phonics. Journal of Deaf Studies and Deaf Education, 13, 405-416. doi:10.1093/deafed/enm064.

O'Connor, R., Jenkins, J., Leicester, N., & Slocum, T. (1993). Teaching phonological awareness to young children with learning disabilities. Exceptional Children, 59, 532-546


Reynolds, A. L., Vick, J. L., & Hank, N. J. (2009). Telehealth applications in speech-language pathology: A modified narrative review. Journal of Telemedicine and Telecare, 15, 310- 316.

Rosenthal, R. & Rosnow, R. L. (1984). Essentials of behavioral research: methods and data analysis. McGraw-Hill, New York.

Schneider, W., Kuspert, P., Roth, E., & Vise, M. (1997). Short and long term effects of training phonological awareness in kindergarten: Evidence from two German studies. Journal of

Experimental Child Psychology, 66, 311-340.

Smith, A., & Wang, Y. (2010). The impact of visual phonics on the phonological awareness and speech production of a student who is deaf: A case study. American Annals of the Deaf,

, 124-130.

Sterne, A., & Goswami, U. (2000). Phonological awareness of syllables, rhymes, and phonemes in deaf children. Journal of Child Psychology and Psychiatry and Allied Disciplines, 41, 609-625.

Syverud, S. M., Guardino, C., & Selznick, D. N. (2009). Teaching phonological skills to a deaf first grader: A promising strategy. American Annals of the Deaf, 154, 382-388.

Texas Essential Knowledge and Skills. (2017). Retrieved from http://tea.texas.gov/index2.aspx?id=6148

Torgesen, J. (2000). Individual differences in response to early interventions in reading: The lingering problem of treatment resisters. Learning Disabilities Research and Practice, 15,


Torgesen, J., Morgan, S.T., & Davis, C. (1992). Effects of two types of phonological awareness training on word learning in kindergarten children. Journal of Educational Psychology, 84, 364-370.

Trezek, B. J., Wang, Y., Woods, D. G., Gampp, T. L., & Paul, P.V. (2007). Using visual phonics to supplement beginning reading instructions for students who are deaf or hard of hearing. Journal of Deaf Studies and Deaf Education, 12, 373-384. doi:10.1093/deafed/enm014

Webb, M.L., & Lederberg, A.R. (2014). Measuring phonological awareness in deaf and hard-of-hearing children. Journal of Speech, Language, and Hearing Research, 57, 131-142.

Werfel, K.L., & Schuele, C.M. (2014). Improving initial sound segmentation skills of preschool children with severe to profound hearing loss: An exploratory investigation. Volta Review, 114, 113-134.

Wiig, E., & Secord, W. (2006). Emerging Literacy & Language Assessment. Greenville, SC: Super Duper Publications

How to Cite
Lee, S. A. S., Hall, B., & Sancibrian, S. (2017). Feasibility of a Supplemental Phonological Awareness Intervention via Telepractice for Children with Hearing Loss: A Preliminary Study. International Journal of Telerehabilitation, 9(1), 23–38. https://doi.org/10.5195/ijt.2017.6216