Duality of patterning has long been recognized as a unique design feature of human language and refers to the distinct bilevel structure in which words comprise one level (semantic) and word-internal, phonetic elements comprise the other level (phonological). This report describes this design feature and offers a perspective on why and how it should help shape reading interventions for children with hearing loss.


Three components comprise this report. The first main section offers an overview of duality of patterning. The second main section reviews results from a longitudinal study illustrating how children with and without hearing loss acquire each level of linguistic structure and how each level contributes to reading acquisition for each group differently. The third main section of this report provides suggestions for how to incorporate this information into interventions for children with hearing loss.


Outcomes presented illustrate that semantic structure begins to take form first, with phonological structure following. Semantic structure is related to reading comprehension, and phonological structure is related to word recognition, at least for alphabetic orthographies. Children with hearing loss acquire a less differentiated linguistic system, with structure at the phonological level only partly or coarsely acquired and with a lack of clear distinction from the semantic level of structure. Consequently, the roles of each level of structure in reading acquisition are less clearly defined for children with hearing loss.


For children with normal hearing, learning to read is compartmentalized: Emerging sensitivity to phonological structure supports development of word recognition, and semantic-level skills support reading comprehension. Hearing loss diminishes language skills overall, but especially phonological sensitivity. Children with hearing loss, especially those with cochlear implants, must rely on all language skills to learn to read, including both word recognition and reading comprehension, which creates a highly inefficient processing strategy.


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