Development of joint engagement in young deaf and hearing children: Effects of chronological age and language skills

Ivette Cejas, David H. Barker, Alexandra L. Quittner, John K. Niparko

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Purpose: To evaluate joint engagement (JE) in age-matched children with and without hearing and its relationship to oral language skills.

Method: Participants were 180 children with severe-toprofound hearing loss prior to cochlear implant surgery, and 96 age-matched children with normal hearing; all parents were hearing. JE was evaluated in a 10-minute videotaped free play task with parents. Engagement states ranged from the lowest (unengaged) to the highest level (symbol-infused coordinated). Standardized language measures were administered.

Results: Multivariate analyses were conducted between the groups, stratified by chronological and language age. Children who were deaf (Deaf) spent less time in total symbol-infused JE than children with normal hearing (NH) across all ages. The majority of the Deaf group (83%) fell in the lowest language age group, in comparison to 35% of the NH group, and spent significantly less time in symbol-infused JE than hearing children. These delays were also observed in the Deaf group, who fell into the 18-36 month language age. No children in the Deaf group had achieved a language age of > 36 months.

Conclusions: Young children with and without hearing had different developmental trajectories of JE, which were related to oral language skills.

Original languageEnglish (US)
Pages (from-to)1831-1841
Number of pages11
JournalJournal of Speech, Language, and Hearing Research
Issue number5
StatePublished - Oct 1 2014
Externally publishedYes


  • Children
  • Hearing loss
  • Joint engagement
  • Language
  • Ochlear implants

ASJC Scopus subject areas

  • Speech and Hearing
  • Language and Linguistics
  • Linguistics and Language


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