The Role of Sentence Position, Allomorph, and Morpheme Type on Accurate Use of s-Related Morphemes by Children Who Are Hard of Hearing

Purpose: Production accuracy of s-related morphemes was examined in 3-year-olds with mild-to-severe hearing loss, focusing on perceptibility, articulation, and input frequency. Method: Morphemes with /s/, /z/, and /iz/ as allomorphs (plural, possessive, third-person singular -s, and auxiliary and copula is) were analyzed from language samples gathered from 51 children (ages: 2; 10 [years; months] to 3; 8) who are hard of hearing (HH), all of whom used amplification. Articulation was assessed via the Goldman-Fristoe Test of Articulation-Second Edition, and monomorphemic word final /s/ and /z/ production. Hearing was measured via better ear pure tone average, unaided Speech Intelligibility Index, and aided sensation level of speech at 4 kHz. Results: Unlike results reported for children with normal hearing, the group of children who are HH correctly produced the /iz/ allomorph more than /s/ and /z/ allomorphs. Relative accuracy levels for morphemes and sentence positions paralleled those of children with normal hearing. The 4-kHz sensation level scores (but not the better ear pure tone average or Speech Intelligibility Index), the Goldman-Fristoe Test of Articulation-Second Edition, and word final s/z use all predicted accuracy. Conclusions: Both better hearing and higher articulation scores are associated with improved morpheme production, and better aided audibility in the high frequencies and word final production of s/z are particularly critical for morpheme acquisition in children who are HH.