PROJECT SUMMARY/ABSTRACT
Reading Outcomes in Children with Vestibular Loss
Vestibular loss can co-occur with hearing loss causing dual sensory deficits. Unfortunately, children with
hearing loss are rarely assessed for vestibular loss. As a result, the impact of co-morbid vestibular loss in children
with hearing loss is unknown, particularly on academic and cognitive outcomes. While vestibular loss has been
speculated to affect reading outcomes in children (Braswell 2006a; Snashall 1983; Tomaz 2014), the extent to
which vestibular loss affects reading outcomes and the association between vestibular loss and reading is not
understood. Therefore, the purpose of this proposal is to investigate the relationship between reading outcomes
and vestibular loss in children with hearing loss. The vestibular system is responsible for decoding head
movement and eliciting eye movements in an equal and opposite direction to maintain steady vision. It is not
surprising therefore that vestibular loss results in reduced dynamic visual acuity – the ability to see clearly during
head movement – (Rine 2003; Janky 2015); however, children with vestibular loss and reduced dynamic visual
acuity also have reduced reading acuity – the smallest print size that can be read – and require larger print size
for reading compared to peers with normal hearing (Braswell 2006a). Thus, Aim 1 will test the hypothesis that
vestibular loss results in visual acuity deficits due to vestibulo-ocular reflex and cognitive deficits, which could
impact reading. Theoretically, the Simple View of Reading (Gough 1986) suggests that reading comprehension
can be explained by decoding and language comprehension abilities; however, these two factors do not account
for all the variance in reading comprehension (Aaron 1999). In children with hearing loss, reading is affected by
language, phonological processing, and auditory access; however, these factors alone do not fully explain the
variance. Aim 2 will test the hypothesis that after controlling for variables known to contribute to reading
performance (i.e., language, phonological processing, auditory access, etc.), vestibular loss will account for a
significant amount of the variance in reading outcomes. The long-term goals of this research program are to
define the developmental and academic impact of comorbid vestibular loss and then develop rehabilitative
strategies that mitigate negative outcomes. The proposed work will provide a better understanding of vestibular
loss as a contributing factor to reading difficulties for children with hearing loss, where previously only the effects
of hearing loss have been considered. The proposed work will improve the scientific understanding of reading
deficits in children with hearing loss and could lead to new rehabilitative interventions for reading in children with
hearing loss by considering vestibular loss, a factor that has until now been ignored. A scaffolded training plan
has been devised to enhance my understanding of literacy outcomes in children with hearing loss, cognition,
neuroanatomy, development, and the ability to incorporate eye tracking to address the hypotheses.