Differences in Language Exposure | Telethon Speech & Hearing

Language Exposure Difference in Children with and without Hearing Loss

In collaboration with Telethon Speech & Hearing (TSH), an honors student in speech pathology conducted a research project. The research compared the quality and quantity of language exposure that children with and without hearing loss experience at home. Both the amount and the type of language that children are exposed to are important for language development.


The study involved using the Language Environment Analysis (LENA) system, an automated language sample collection and analysis system that records and estimates a number of useful measures (1). Parents help children wear a specially designed shirt that holds a small recording device at the beginning of the day. The device then records the auditory information present within a three meter radius of the child up to 16 hours. When the device is connected to a computer, the LENA system estimates the number of child vocalisation, the number of adult-child conversational turns, the number of adult words that the child was exposed to, and the acoustic environment. TSH’s Chatterbox – Early Intervention program has been using this innovative system to give parents feedback about children’s language and acoustic environment outside of therapy.


The study analysed LENA data of five children with hearing loss (chronological age: 35 – 51 months; hearing age: 26 – 48 months), and five children with normal hearing matched by hearing age (+3 months) and gender. Children with hearing loss had either hearing aids or cochlear implants, or both.


Overall, the study found that the children with hearing loss were not exposed to fewer adult words, they did not vocalise less, and they did not participate in conversational exchanges with their caregivers less often than the children with normal hearing. This may be because of the therapy that focuses on guiding and coaching caregivers to be the primary facilitators of their child’s listening, language and speech development.


There were however, some differences found in the quality of language at home. Children with hearing loss were participating in successful conversation less frequently, unable to maintain topic, and received fewer caregiver expansions. The findings of the study have been published (2).


TSH conducted a couple of research projects using LENA. We investigated the perceptions of parents regarding the use of the LENA in the therapy. The findings indicated that parents found the use of LENA in therapy to be beneficial. We also examined the effect of LENA data feedback that our Chatterbox therapists provided to parents on home language environment of children with hearing loss. The findings suggest the LENA feedback in the therapy has a positive impact on parent-child interactions at home. LENA has a great potential as a therapy tool in the Chatterbox program.


For a list of all research publications and projects Telethon Speech & Hearing is involved with, click here.



  1. LENA Research Foundation. LENA Research Foundation 2015 Available from:
  2. Saetre-Turner M, Williams C, Quail M. The quality and quantity of caregiver-child interaction in hearing impaired and normally hearing children. The Journal of Clinical Practice in Speech-Language Pathology (JCPSLP). 2015;17:144-50.
  3. Kishida Y, Williams C. Using Language Environment Analysis (LENA) in Auditory-Verbal Therapy: Perceptions of parents of children with hearing impairment. Speech Pathology Australia National Conference – Making Waves; 15-18 May 2017; Perth May, 2016.