Universal screening of newborns for hearing loss before they leave the hospital is not enough to improve language skills of children who are deaf and hard of hearing, according to a new study.

Research scientists at Cincinnati Children’s Hospital Medical Center say that at least 40 percent of children with a hearing loss have the capacity for higher language levels – beyond what test scores indicate.

“We have focused efforts for children who are deaf or hard of hearing on obtaining a language level that is often considered in the normal or average range on standardized assessments,” said Jareen Meinzen-Derr, PhD, an epidemiologist at Cincinnati Children’s and lead author of a new study. ”But their language skills are not good enough if we account for their cognitive abilities.”

Meinzen-Derr said there is a mismatch between the cognitive level children test at and the expectations for their language skills. With a slightly modified evaluation approach, therapists would be able to recognize these mismatches at very young ages, she said, and intervene to bring these children up to their ability.

“We should not be satisfied with language levels that are lower than a child’s cognitive ability.”

The study was published online in the Journal of Developmental and Behavioral Pediatrics.

Researchers conducted the study in two phases. The first occurred between 2011 and 2014 and enrolled children between the ages of 3 and 6 with bilateral mild to profound hearing loss. The second phase began in 2014 and enrolled children up to 3 years old, also with mild to profound bilateral hearing loss. A total of 152 children were enrolled.

All children received a language assessment and a neurocognitive assessment. A speech-language pathologist administered a standardized test to assess language skills. Forty-one percent had a significant disparity between their language scores and their nonverbal cognitive scores, which the researchers defined as a “language underperformance.”

“We believe that all children have potential,” said Meinzen-Derr. “Our measurements give us a target for that potential so that we at least know what the language goals for a child should be. This also has implications for other aspects of development, such as social development and – further down the road – academics. This is why we are pushing for better intervention, because we know we can do better for children who are deaf or hard of hearing.”