Foundational Questions: A Researcher’s ASHFoundation-Launched Quest for Answers Name: Krystal Werfel, PhD, CCC-SLP Title: Assistant professor, Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina ASHFoundation Awards: Over the past 40 years, there have been major advances in amplification technology for children with hearing loss, including FDA approval of cochlear ... Foundational Questions
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Foundational Questions  |   April 01, 2016
Foundational Questions: A Researcher’s ASHFoundation-Launched Quest for Answers
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Hearing Disorders / ASHA News & Member Stories / Foundational Questions
Foundational Questions   |   April 01, 2016
Foundational Questions: A Researcher’s ASHFoundation-Launched Quest for Answers
The ASHA Leader, April 2016, Vol. 21, online only. doi:10.1044/leader.FQ.21042016.np
The ASHA Leader, April 2016, Vol. 21, online only. doi:10.1044/leader.FQ.21042016.np
Name: Krystal Werfel, PhD, CCC-SLP
Title: Assistant professor, Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina
ASHFoundation Awards:
  • 2013 New Investigators Research Grant ($5,000), “Contributions of Phonological Processing to Reading and Spelling Achievement in School-Age Children with Cochlear Implants”

  • 2010 New Century Scholars Doctoral Scholarship ($10,000)

  • 2010 ASHA Research Conference Travel Grant

  • 2009 Student Research Grant in Early Childhood Language ($2,000), “Phonological Awareness Training in Children with Hearing Loss”

What is the focus of your research?
Over the past 40 years, there have been major advances in amplification technology for children with hearing loss, including FDA approval of cochlear implants; however, a large subgroup of children with hearing loss still experiences difficulty with literacy achievement. In fact, the median reading outcomes for children with hearing loss haven’t increased since the 1970s. My current work focuses on identifying early language predictors of later literacy outcomes for children with hearing loss, as well as developing effective early literacy interventions for these children. The overarching goals of my work are to increase our scientific understanding of literacy acquisition for children with hearing loss and use that understanding to provide more effective interventions for them.
How did your award from the ASHFoundation lead to your current work?
The ASHFoundation has played a major role in advancing my research to its current point. As a doctoral student, I received a Student Research Grant in Early Childhood Language Development to study the effectiveness of teaching phonological awareness to preschoolers with hearing loss. In this study, we demonstrated that children with hearing loss benefit from intensive phonological awareness intervention.
The findings of that study, along with a collaborative study on early literacy skills in children with hearing loss with Emily Lund and Melanie Schuele, led to a New Investigators Research Grant to study the impact of phonological processing on reading and spelling in school-age children with cochlear implants. In this study, we found that phonological processing skills appear to predict literacy differently in children with cochlear implants than in children with normal hearing and that fatigue plays a role in language and literacy performance.
These two studies motivated my current interest in predictors of literacy achievement in children with hearing loss. In my lab, we are working on an NIH-funded study to identify early predictors so that clinically we can identify the children who most need intensive early intervention, particularly early literacy intervention. We are also working to develop early literacy interventions to help close the gap between these children with hearing loss and their peers with normal hearing.
What do you hope to demonstrate through your research—or what has it already demonstrated?
My work in early literacy has shown that children with hearing loss develop oral language, phonological awareness and print knowledge skills later than children with normal hearing, and that children with hearing loss learn them in perhaps fundamentally different ways. Children with hearing loss appear to acquire vocabulary knowledge and learn to analyze the sounds of words differently than children with normal hearing. The phonological processing skills of children with hearing loss generally are delayed and predict literacy differently than in children with normal hearing. Additionally, their conceptual print knowledge is delayed relative to children with normal hearing. We have also demonstrated that effective early literacy interventions can result in gains for children with hearing loss. The challenge now is to optimize these interventions to address difficulties in literacy achievement as early as possible in development.
In my current work, funded by NIH, we are tracking the development of early language and literacy skills across the preschool years to determine early predictors of literacy outcomes. We will analyze our data in two ways.
First, we will look at the developmental trajectories of children with hearing loss compared to children with normal hearing. This comparison will give some insight into fundamental differences in acquisition of these skills across the two groups as well as give some indication as to whether interventions designed originally for children with normal hearing are likely to be effective for children with hearing loss.
The second way is to divide the children with hearing loss into groups based on their literacy outcomes and determine the differences between children with hearing loss who have high literacy skills and children with hearing loss who have low literacy skills. This comparison may yield further understanding of the characteristics of children with hearing loss who do not experience difficulty with literacy, as well as potential intervention strategies for the low group.
Why did you choose this particular research focus?
I began studying early literacy in children with hearing loss as an undergraduate at the University of Tennessee. I was an early childhood education major, and my advisor had been a speech-language pathologist before becoming a teacher educator. She recommended that I consider speech-language pathology as a career, because I had a focused interest in literacy acquisition. As a result of her advice, I completed an undergraduate thesis with Ilsa Schwarz, using curriculum-based measures to monitor early literacy acquisition in children with hearing loss. I knew very little about hearing loss prior to that experience, and mostly thought of it in terms of losing your hearing as you age. Through that experience, I began to learn about educational issues for children with hearing loss.
From that very first study, I have found myself fascinated with how linguistic deficits can interact with prelinguistic hearing loss and result in much lower-than-expected literacy outcomes for the population. I went on to Vanderbilt University, where I completed a master’s in speech-language pathology with an emphasis in interdisciplinary support for children with hearing loss, and a PhD in hearing and speech sciences. I then completed a postdoctoral fellowship with Fred Bess, studying the effects of listening effort on fatigue and learning for children with hearing loss.
How has ASHFoundation funding affected your professional life?
I know without a doubt that my career would not be where it is today without the support of the ASHFoundation. I have received two research grants that provided vital preliminary data for my current NIH-funded study; the New Century Doctoral Scholarship supported, in part, my dissertation work; and funding to participate in Lessons for Success, a grant-writing conference for early-career researchers.
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