The approximate number system and domain-general abilities as predictors of math ability in children with normal hearing and hearing loss.

Many children with hearing loss (CHL) show a delay in mathematical achievement compared to children with normal hearing (CNH). This study examined whether there are differences in acuity of the approximate number system (ANS) between CHL and CNH, and whether ANS acuity is related to math achievement. Working memory (WM), short-term memory (STM), and inhibition were considered as mediators of any relationship between ANS acuity and math achievement. Seventy-five CHL were compared with 75 age- and gender-matched CNH. ANS acuity, mathematical reasoning, WM, and STM of CHL were significantly poorer compared to CNH. Group differences in math ability were no longer significant when ANS acuity, WM, or STM was controlled. For CNH, WM and STM fully mediated the relationship of ANS acuity to math ability; for CHL, WM and STM only partially mediated this relationship. ANS acuity, WM, and STM are significant contributors to hearing status differences in math achievement, and to individual differences within the group of CHL. Statement of contribution What is already known on this subject? Children with hearing loss often perform poorly on measures of math achievement, although there have been few studies focusing on basic numerical cognition in these children. In typically developing children, the approximate number system predicts math skills concurrently and longitudinally, although there have been some contradictory findings. Recent studies suggest that domain-general skills, such as inhibition, may account for the relationship found between the approximate number system and math achievement. What does this study adds? This is the first robust examination of the approximate number system in children with hearing loss, and the findings suggest poorer acuity of the approximate number system in these children compared to hearing children. The study addresses recent issues regarding the contradictory findings of the relationship of the approximate number system to math ability by examining how this relationship varies across children with normal hearing and hearing loss, and by examining whether this relationship is mediated by domain-general skills (working memory, short-term memory, and inhibition).