Caregiver response types and children language outcomes in preschoolers with and without hearing loss in Aotearoa New Zealand.

Recent advances in audiological early intervention and hearing technologies have significantly improved access to spoken language for children with hearing loss (CwHL), but many CwHL require additional support to match the language development of their peers with normal hearing (PwNH). Programmes such as It Takes Two to Talk®, the Hanen Program® and Talking Matters focus on supporting parents to enhance children's language development in natural environments. Analysis of response types has become a significant trend, facilitated by technological developments like Language ENvironment Analysis (LENA®), which provides uninterrupted recordings and automated calculations of adult-child interactions. This research examined three child language measures, child vocalisation counts, total number of words, and mean length of utterance, comparing CwHL and PwNH. Transcribed excerpts of LENA recordings were coded to determine caregivers' use of 'high-level' responses in exchanges with their children and were correlated with child language outcomes. The results confirm the crucial role of caregiver response types in enhancing child language outcomes and exemplify the bidirectional relationship of caregiver-child interactions. The findings add to the literature to suggest that families and educators would benefit from guidance and coaching to acquire and apply high-level response types during natural spoken language interactions with CwHL.