Inclusion Criteria:  Age 3-10 years Documented permanent bilateral hearing loss with severity levels clinically defined moderate to profound). Identified with a language deficit, defined by either the ratio of language standard scores to nonverbal intelligence quotient <.85 or a differences in nonverbal IQ and language standard scores of 10 points. Language scores may either be receptive or expressive. Currently receiving speech-language therapy.  Exclusion Criteria:  Mild hearing loss and unilateral hearing loss  primary language other than English significant motor impairments nonverbal IQ <80 children with severe communication disorders (i.e. autism spectrum disorders).