# Brain Mechanisms underlying skilled reading in deaf and hard of hearing (DHH) children with different communication modes

> **NIH NIH R01** · VANDERBILT UNIVERSITY · 2021 · $760,883

## Abstract

PROJECT SUMMARY
 Many deaf and hard-of-hearing (DHH) children struggle with reading and the severity of the impairment for some
children increases with age. Despite this, we know very little about the brain mechanisms for successful reading in
DHH children, or whether reliance on certain mechanisms differs with communication mode. We do not know why
some DHH children are good readers and other are not. We take advantage of the large individual differences in
reading skill to determine how better reading relies on different mechanisms and whether this varies with
communication modes. This project uses functional magnetic resonance imaging (fMRI) in 10- to 15-year-old hearing
children as well as in DHH children with predominant signed language, predominant oral language, or bimodal
language. The innovative longitudinal approach follows children two years later and allows an investigation of how
reading gains are related to brain changes over time and whether this varies with age. The overarching theory of
reading acquisition is the Triangle Model which has three representational systems, including orthography (spelling),
phonology (sound) and semantics (meaning), as well as pathways for mapping between these systems. A
fundamental strength of this project is extending the well-developed Triangle Model to formulate the first
neurocognitive model of reading in DHH children. Our project tests critical assumptions of the Triangle Model including
the nature of orthographic representations, of orthographic to phonological mapping and of orthographic to semantic
mapping. We test how these components are related to skill and developmental change over time in DHH children
with different communication modes. Another innovative aspect of the project is the use of `localizer' fMRI tasks to
independently identify regions associated with phonological mechanisms in temporo-parietal cortex during speech
reading, signed language and spoken phonology, as well as regions associated with semantic mechanisms in middle
temporal gyrus. The use of independent localizer tasks provides fundamental advances in our understanding of the
underlying neural mechanisms involved in skilled reading in DHH children. Children also complete two reading fMRI
tasks, one involving rhyming judgments and the other involving meaning judgments to words presented visually. Not
only do we examine how phonological and semantic mechanisms are related to reading, but our novel approach also
examines connectivity of these regions with fusiform cortex involved in orthographic processing. In addition to the
fMRI measures, all children complete an extensive battery of state-of-the-art behavioral tests measuring signed
language, oral language and reading. The focus of the project is on individual differences on word decoding as this is
a critical building block to reading, but we also examine behavioral differences in reading comprehension.

## Key facts

- **NIH application ID:** 10237151
- **Project number:** 5R01DC018171-03
- **Recipient organization:** VANDERBILT UNIVERSITY
- **Principal Investigator:** James R Booth
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $760,883
- **Award type:** 5
- **Project period:** 2019-09-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10237151

## Citation

> US National Institutes of Health, RePORTER application 10237151, Brain Mechanisms underlying skilled reading in deaf and hard of hearing (DHH) children with different communication modes (5R01DC018171-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10237151. Licensed CC0.

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