Archive for July, 2009

Executive Function and Hearing Loss

July 27, 2009

I just flew back from the LSL symposium in St. Louis.  Wow!  lots of new information!

There were plenty of great presenters sharing their research on the impact of executive function on educational and developmental outcomes.  It seems to me that there is still a long way to go to nail down exactly how hearing loss effects executive function, but we know that it does.

Disorders of Executive Function can be thought of as a combination of abilities for:

Working memory



In short, it can be described as the ability to hold information in your mind, be flexible with it, shift (topic, structure, environment, etc.) and still retrieve the information among distractors.  Kids with disorders of executive function might have an inherent knowledge of the “details” but have difficulty integrating them into everyday life.

Part of normal executive function is abstracting information from the environment and using it.  This could be vocabulary, grammar, problem solving skills, etc.  What we know is that a child with a hearing loss will have problems grasping ALL of the information in the environment, therefore predisposing them to disorders of executive function.  The good news is that there are things we can do to work on that.

Researchers that presented at the symposium (Anne Geers, David Pisoni, Kim Espy, Mich Sommers, etc) stated that executive function skills can account for up to 60% of “success” with cochlear implants.  In other words, 60% of the recipient’s success can be attributed to the executive function skills they had before implantation.  No one has really looked at whether or not a cochlear implant can improve executive function.  My guess is that learning to listen, with whatever hearing you have, will lead to pro-executive function.  I might be going out on a limb here ….but  this is another reason that what you do before the implant really matters.

At Sound Speech & Hearing we address executive function on a variety of levels, mostly depending on the developmental level of the child and/or a weakness that has presented itself.  I’ve listed an example of some of the goals we use to target executive function.  Now- you may look at them and think…What does this have to do with hearing loss?  My answer is simple.  Sometimes you just need to have your work/environment/thoughts/time organized, before you can focus on listening.

For many of us, these skills come naturally.  For others (including myself sometimes!) we need to be reminded that some organization is essential.

Following Directions

  • Read the directions
  • Scan the whole page
  • Re-read the directions
  • Underline the words that tell you to do something
  • Begin your work

Time Management

  • Prioritizing Tasks and Time
  • Sensing the Sweep of Time (how much time do I think I will need?)
  • Charting out the tasks before you attempt them
  • Following the steps listed on the board or paper taped to desk

Independent Work Preparation

  • Review of past testing skills (how did I do on the last test?)
  • Anticipation of Format and Content of assignment or test
  • Strategies for organization and execution
  • Planning and estimating time during the test or assignment
  • Evaluating performance and planning for future assignments

Reading and Listening Comprehension

  • Visualization of text or story
  • Understand the organization of the story
  • Main idea vs unimportant details
  • Note taking and techniques for storage of information
  • Understanding of novel vocabulary based on context clues
  • Reasoning skills for inference, predictions, etc.