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Davidson K, Lillo-Martin D, Chen Pichler D. Spoken english language development among native signing children with cochlear implants. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2014; 19:238-50. [PMID: 24150489 PMCID: PMC3952677 DOI: 10.1093/deafed/ent045] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Bilingualism is common throughout the world, and bilingual children regularly develop into fluently bilingual adults. In contrast, children with cochlear implants (CIs) are frequently encouraged to focus on a spoken language to the exclusion of sign language. Here, we investigate the spoken English language skills of 5 children with CIs who also have deaf signing parents, and so receive exposure to a full natural sign language (American Sign Language, ASL) from birth, in addition to spoken English after implantation. We compare their language skills with hearing ASL/English bilingual children of deaf parents. Our results show comparable English scores for the CI and hearing groups on a variety of standardized language measures, exceeding previously reported scores for children with CIs with the same age of implantation and years of CI use. We conclude that natural sign language input does no harm and may mitigate negative effects of early auditory deprivation for spoken language development.
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Affiliation(s)
- Kathryn Davidson
- Department of Linguistics, Yale University, Dow Hall, 370 Temple Street, New Haven, CT 06520-8366.
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152
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Sundqvist A, Lyxell B, Jönsson R, Heimann M. Understanding minds: early cochlear implantation and the development of theory of mind in children with profound hearing impairment. Int J Pediatr Otorhinolaryngol 2014; 78:537-43. [PMID: 24485174 DOI: 10.1016/j.ijporl.2013.12.039] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 12/28/2013] [Accepted: 12/30/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The present study investigates how auditory stimulation from cochlear implants (CI) is associated with the development of Theory of Mind (ToM) in severely and profoundly hearing impaired children with hearing parents. Previous research has shown that deaf children of hearing parents have a delayed ToM development. This is, however, not always the case with deaf children of deaf parents, who presumably are immersed in a more vivid signing environment. METHODS Sixteen children with CI (4.25 to 9.5 years of age) were tested on measures of cognitive and emotional ToM, language and cognition. Eight of the children received their first implant relatively early (before 27 months) and half of them late (after 27 months). The two groups did not differ in age, gender, language or cognition at entry of the study. ToM tests included the unexpected location task and a newly developed Swedish social-emotional ToM test. The tests aimed to test both cognitive and emotional ToM. A comparison group of typically developing hearing age matched children was also added (n=18). RESULTS Compared to the comparison group, the early CI-group did not differ in emotional ToM. The late CI-group differed significantly from the comparison group on both the cognitive and emotional ToM tests. CONCLUSION The results revealed that children with early cochlear implants solved ToM problems to a significantly higher degree than children with late implants, although the groups did not differ on language or cognitive measures at baseline. The outcome suggests that early cochlear implantation for deaf children in hearing families, in conjunction with early social and communicative stimulation in a language that is native to the parents, can provide a foundation for a more normalized ToM development.
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Affiliation(s)
- Annette Sundqvist
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
| | - Björn Lyxell
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden
| | - Radoslava Jönsson
- Sahlgrenska University Hospital, Department of Otolaryngology and The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mikael Heimann
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden
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153
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Phillips J, Wiley S, Barnard H, Meinzen-Derr J. Comparison of two nonverbal intelligence tests among children who are deaf or hard-of-hearing. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:463-471. [PMID: 24361815 DOI: 10.1016/j.ridd.2013.11.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 11/15/2013] [Accepted: 11/18/2013] [Indexed: 06/03/2023]
Abstract
The primary goal of the current study is to evaluate the concurrent validity of the Leiter International Performance Scale-Revised (Leiter-R Brief IQ) and Differential Ability Scales - Second Edition (DAS-II Nonverbal Reasoning Index) in a group of children who are deaf or hard-of-hearing. Knowing the breadth of cognitive tools appropriate for use in children who are deaf or hard-of-hearing is highly beneficial, given that clinical and school psychologists are often challenged to reliably assess cognitive functions in the context of hearing loss. Participants included 54 children between three and six years of age with permanent bilateral hearing loss. As part of the study, neurocognitive assessments were conducted by a pediatric neuropsychologist or licensed clinical psychologist with extensive experience administering assessments to children with developmental disabilities, including children with hearing loss. The Leiter-R Brief IQ score was similar to the DAS-II nonverbal reasoning index, with no significant difference in the mean scores across the two assessments. The severity of hearing loss was not correlated to either the Leiter-R or the DAS-II nonverbal IQ. Nearly a quarter of the children evaluated had meaningful intra-individual differences between scores on the Leiter-R and DAS-II that were more than one standard deviation from one another. Conducting accurate intellectual assessments in children who are deaf and hard-of-hearing is fundamental in determining and designing interventions and educational services. More comprehensive neuropsychological test batteries utilizing several tasks to assess a single domain (such as nonverbal reasoning) may be warranted for children who are deaf or hard-of-hearing.
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Affiliation(s)
- Jannel Phillips
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Susan Wiley
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Holly Barnard
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Jareen Meinzen-Derr
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
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Fulcher A, Baker E, Purcell A, Munro N. Typical consonant cluster acquisition in auditory-verbal children with early-identified severe/profound hearing loss. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2014; 16:69-81. [PMID: 24001172 DOI: 10.3109/17549507.2013.808698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Early-identified severe/profound hearing loss (HL) following universal newborn hearing screening (UNHS) has been associated with improved speech and language outcomes. However, speech outcome reports have typically been based on broad measures of speech intelligibility and/or singleton consonant accuracy, with little known about production of consonant clusters. Using a prospective design, the range and accuracy of consonant clusters produced by a homogenous cohort of 12 children early-identified with severe/profound HL aged 3- and 4-years were examined. All children demonstrated bilateral aided thresholds within a range of 15-25 dB HL across all frequencies, were optimally amplified with cochlear implants (11/12) or hearing aids (1/12), and attended auditory-verbal (AV) early intervention. Standardized speech and language assessments were administered. Consonant clusters were strategically sampled in single-word and conversational speech contexts. All standard scores for speech, receptive, and expressive language were within normal limits. All children produced consonant clusters commensurate with expectations for typically-developing hearing peers at 3- and 4- years-of-age. Children's production of phonetically complex morphophonemes (final consonant clusters marking grammatical morphemes) was also in keeping with developmental expectations. Factors which contributed to these encouraging outcomes require further investigation.
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155
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Giezen MR, Baker AE, Escudero P. Relationships between spoken word and sign processing in children with cochlear implants. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2014; 19:107-125. [PMID: 24080074 DOI: 10.1093/deafed/ent040] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The effect of using signed communication on the spoken language development of deaf children with a cochlear implant (CI) is much debated. We report on two studies that investigated relationships between spoken word and sign processing in children with a CI who are exposed to signs in addition to spoken language. Study 1 assessed rapid word and sign learning in 13 children with a CI and found that performance in both language modalities correlated positively. Study 2 tested the effects of using sign-supported speech on spoken word processing in eight children with a CI, showing that simultaneously perceiving signs and spoken words does not negatively impact their spoken word recognition or learning. Together, these two studies suggest that sign exposure does not necessarily have a negative effect on speech processing in some children with a CI.
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Affiliation(s)
- Marcel R Giezen
- Laboratory for Language and Cognitive Neuroscience, San Diego State University, 6495 Alvarado Road, Suite 200, San Diego, CA 92120.
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156
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Davidson LS, Geers AE, Nicholas JG. The effects of audibility and novel word learning ability on vocabulary level in children with cochlear implants. Cochlear Implants Int 2013; 15:211-21. [PMID: 23998324 DOI: 10.1179/1754762813y.0000000051] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES A novel word learning (NWL) paradigm was used to explore underlying phonological and cognitive mechanisms responsible for delayed vocabulary level in children with cochlear implants (CIs). METHODS One hundred and one children using CIs, 6-12 years old, were tested along with 47 children with normal hearing (NH). Tests of NWL, receptive vocabulary, and speech perception at 2 loudness levels were administered to children with CIs. Those with NH completed the NWL task and a receptive vocabulary test. CI participants with good audibility (GA) versus poor audibility (PA) were compared on all measures. Analysis of variance was used to compare performance across the children with NH and the two groups of children with CIs. Multiple regression analysis was employed to identify independent predictors of vocabulary outcomes. RESULTS Children with CIs in the GA group scored higher in receptive vocabulary and NWL than children in the PA group, although they did not reach NH levels. CI-aided pure tone threshold and performance on the NWL task predicted independent variance in vocabulary after accounting for other known predictors. DISCUSSION Acquiring spoken vocabulary is facilitated by GA with a CI and phonological learning and memory skills. Children with CIs did not learn novel words at the same rate or achieve the same receptive vocabulary levels as their NH peers. Maximizing audibility for the perception of speech and direct instruction of new vocabulary may be necessary for children with CIs to reach levels seen in peers with NH.
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157
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Boons T, De Raeve L, Langereis M, Peeraer L, Wouters J, van Wieringen A. Narrative spoken language skills in severely hearing impaired school-aged children with cochlear implants. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:3833-3846. [PMID: 24029803 DOI: 10.1016/j.ridd.2013.07.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 07/25/2013] [Accepted: 07/30/2013] [Indexed: 06/02/2023]
Abstract
Cochlear implants have a significant positive effect on spoken language development in severely hearing impaired children. Previous work in this population has focused mostly on the emergence of early-developing language skills, such as vocabulary. The current study aims at comparing narratives, which are more complex and later-developing spoken language skills, of a contemporary group of profoundly deaf school-aged children using cochlear implants (n=66, median age=8 years 3 months) with matched normal hearing peers. Results show that children with cochlear implants demonstrate good results on quantity and coherence of the utterances, but problematic outcomes on quality, content and efficiency of retold stories. However, for a subgroup (n=20, median age=8 years 1 month) of deaf children without additional disabilities who receive cochlear implantation before the age of 2 years, use two implants, and are raised with one spoken language, age-adequate spoken narrative skills at school-age are feasible. This is the first study to set the goals regarding spoken narrative skills for deaf children using cochlear implants.
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Affiliation(s)
- Tinne Boons
- ExpORL, Department Neurosciences, KU Leuven, Leuven, Belgium; Institute of Allied Health Sciences, Fontys University of Applied Sciences, Eindhoven, The Netherlands.
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158
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Rinaldi P, Baruffaldi F, Burdo S, Caselli MC. Linguistic and pragmatic skills in toddlers with cochlear implant. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2013; 48:715-725. [PMID: 24165367 DOI: 10.1111/1460-6984.12046] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND An increasing number of deaf children received cochlear implants (CI) in the first years of life, but no study has focused on linguistic and pragmatic skills in children with CI younger than 3 years of age. AIMS To estimate the percentage of children who had received a CI before 2 years of age whose linguistic skills were within the normal range; to compare linguistic skills of children implanted by 12 months of age with children implanted between 13 and 26 months of age; and to describe the relationship among lexical, grammar and pragmatic skills. METHODS & PROCEDURES The participants consisted of children who were included on the patient lists of the Service of Audio-Vestibology of the Circolo Hospital in Varese, Italy, and met the following criteria: chronological age between 18 and 36 months; CI activated between 8 and 30 months of age; absence of other reported deficits; hearing parents; and not less than 6 months of CI experience. Language development was evaluated through MacArthur-Bates CDI; pragmatic skills (assertiveness and responsiveness) were evaluated through the Social Conversational Skills Rating Scale. The scores obtained were transformed into z-scores and compared with normative data. The relationship among lexical, grammar and pragmatic skills were tested using Spearman Rho correlations. Children with CI were divided into groups based on the age at CI activation and the differences between the two groups were tested using the Student's t-test. OUTCOMES & RESULTS Data from 23 deaf children were collected. Fewer than half of the children were within the normal range for lexical production and use of sentences; more than one-third of them fell below the normal range for both lexical and grammar skills. No significant difference was found in vocabulary size or early grammar skills when comparing children who received the CI by 12 months of age with those implanted during the second year of life. Despite the strong relationship among lexical, grammar and pragmatic skills, the delays found for grammar and pragmatic skills were greater than expected based on the vocabulary size. Age at diagnosis of hearing loss was the only predictor of vocabulary size. CONCLUSIONS & IMPLICATIONS CI may provide deaf children with a good opportunity to develop language skills, but severe difficulties in early social experiences and interaction mediated by language still remain. Delays in these aspects suggest that interventions improving pragmatic skills are recommended even on very young children with CI.
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Affiliation(s)
- Pasquale Rinaldi
- Istituto di Scienze e Tecnologie della Cognizione-CNR, Rome, Italy
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159
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Abstract
BACKGROUND After cochlear implantation, most parents expect a normal speech and general development of their child. However, it remains unclear how quickly after early cochlear implantation these children can compensate for their deficits compared to normal-hearing children. METHODS This study retrospectively analyzed ELFRA-1 questionnaire data from 40 children with borderline deafness or high-grade hearing loss (without other known impairments) who had undergone cochlear implantation at a university medical center before reaching 2 years of age. ELFRA-1 questionnaires were filled out parents assisted by specialists 12 months after implantation. Questions assessed the children's speech production and comprehension, as well as their use of gestures and fine motoric skills. RESULTS At an average hearing-age of 12 months, the children achieved normal values in all of the subgroups that were comparable to those of 12-month-old children without hearing impairments. A significant correlation (p = 0.01) between the individual subgroups of the ELFRA-1 (speech production, speech comprehension, gestures and fine motor skills) was observed. Unilingual educated children performed significantly better overall. CONCLUSION Within 12 months of receiving a cochlear implant, all children passed the four categories of the ELFRA-1. This demonstrates a rapid compensation of deficits in speech, motor skills and gesture development by children undergoing early cochlear implantation.
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160
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Abstract
Cochlear implantation is a revolutionary yet time-sensitive treatment for deaf children that must be performed within a critical window of time, in early life, for a congenitally deafened child to receive maximum benefit. Potential candidates should therefore be referred for evaluation early. Primary reasons for delay of cochlear implantation include slow referrals for care, parental delays, and payer delays. It is vital that all newborn children undergo hearing screening to identify deaf children at birth, and for parents, health care providers, and health care payers to be educated about the indications, important benefits, and reasonable risks of cochlear implantation for deaf children.
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Affiliation(s)
- Joseph L Russell
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA
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161
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Kosaner J, Sonuguler S, Olgun L, Amann E. Young cochlear implant users' auditory development as measured and monitored by the LittlEARS® Auditory Questionnaire: a Turkish experience. Int J Pediatr Otorhinolaryngol 2013; 77:1359-63. [PMID: 23810550 DOI: 10.1016/j.ijporl.2013.05.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 04/22/2013] [Accepted: 05/26/2013] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This study aims to assess the usefulness of the LittlEARS(®) Auditory Questionnaire (LEAQ) in determining the audiological development of Turkish children who have received a cochlear implant. METHODS 20 children received a cochlear implant before their 3rd birthday. Each child's progress was evaluated with the LittlEARS(®) Auditory Questionnaire at first device fitting and then at 3-month intervals for 2 years. Scores were compared with the age-related norms established by hearing children. RESULTS All children showed a significant increase in LittlEARS(®) Auditory Questionnaire scores over time. Nearly all children showed a growth in auditory skills similar to that of hearing children. Children without additional needs showed more development than did children with additional needs. CONCLUSIONS The LittlEARS(®) Auditory Questionnaire is useful for monitoring the audiological development of young children with a cochlear implant. Confirmation that a cochlear implant user is achieving typical auditory milestones serves to boost parental morale during a child's pre-verbal stage when parents may be anxious about their child's ability to talk. The questionnaire could also be useful as an early warning system. Poor scores likely indicate that something is impeding the child's development. This should prompt professionals to try to identify the impediment, whether technical, medical, social or educational and, possibly, eliminate/mitigate its effects while the child is still in his/her critical development stages.
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Affiliation(s)
- Julie Kosaner
- MED-EL Worldwide Headquarters, Fuerstenweg 77a, 6020 Innsbruck, Austria.
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162
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Fitzpatrick EM, Olds J, Gaboury I, McCrae R, Schramm D, Durieux-Smith A. Comparison of outcomes in children with hearing aids and cochlear implants. Cochlear Implants Int 2013; 13:5-15. [DOI: 10.1179/146701011x12950038111611] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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163
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Mahon M, Vickers D, McCarthy K, Barker R, Merritt R, Szagun G, Mann W, Rajput K. Cochlear-implanted children from homes where English is an additional language: findings from a recent audit in one London centre. Cochlear Implants Int 2013; 12:105-13. [DOI: 10.1179/146701010x486552] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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164
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Hopyan T, Gordon KA, Papsin BC. Identifying emotions in music through electrical hearing in deaf children using cochlear implants. Cochlear Implants Int 2013; 12:21-6. [DOI: 10.1179/146701010x12677899497399] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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165
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Cardon G, Sharma A. Central auditory maturation and behavioral outcome in children with auditory neuropathy spectrum disorder who use cochlear implants. Int J Audiol 2013; 52:577-86. [PMID: 23819618 DOI: 10.3109/14992027.2013.799786] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE We examined cortical auditory development and behavioral outcomes in children with ANSD fitted with cochlear implants (CI). DESIGN Cortical maturation, measured by P1 cortical auditory evoked potential (CAEP) latency, was regressed against scores on the infant toddler meaningful auditory integration scale (IT-MAIS). Implantation age was also considered in relation to CAEP findings. STUDY SAMPLE Cross-sectional and longitudinal samples of 24 and 11 children, respectively, with ANSD fitted with CIs. RESULTS P1 CAEP responses were present in all children after implantation, though previous findings suggest that only 50-75% of ANSD children with hearing aids show CAEP responses. P1 CAEP latency was significantly correlated with participants' IT-MAIS scores. Furthermore, more children implanted before age two years showed normal P1 latencies, while those implanted later mainly showed delayed latencies. Longitudinal analysis revealed that most children showed normal or improved cortical maturation after implantation. CONCLUSION Cochlear implantation resulted in measureable cortical auditory development for all children with ANSD. Children fitted with CIs under age two years were more likely to show age-appropriate CAEP responses within six months after implantation, suggesting a possible sensitive period for cortical auditory development in ANSD. That CAEP responses were correlated with behavioral outcome highlights their clinical decision-making utility.
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Affiliation(s)
- Garrett Cardon
- Department of Speech, Language, and Hearing Sciences, University of Colorado, Boulder, USA
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166
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Boons T, De Raeve L, Langereis M, Peeraer L, Wouters J, van Wieringen A. Expressive vocabulary, morphology, syntax and narrative skills in profoundly deaf children after early cochlear implantation. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:2008-2022. [PMID: 23584181 DOI: 10.1016/j.ridd.2013.03.003] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 03/01/2013] [Accepted: 03/04/2013] [Indexed: 06/02/2023]
Abstract
Practical experience and research reveal generic spoken language benefits after cochlear implantation. However, systematic research on specific language domains and error analyses are required to probe sub-skills. Moreover, the effect of predictive factors on distinct language domains is unknown. In this study, outcomes of 70 school-aged children with cochlear implants were compared with hearing peers. Approximately half of the children with cochlear implants achieved age-adequate language levels. Results did not reveal systematic strong or weak language domains. Error analyses showed difficulties with morphological and syntactic rules and inefficient narrative skills. Children without additional disabilities who received early intervention were raised with one spoken language, and used a second cochlear implant or contralateral hearing aid were more likely to present good language skills.
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Affiliation(s)
- Tinne Boons
- ExpORL, Department Neurosciences, KU Leuven, Leuven, Belgium.
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167
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Nicholas JG, Geers AE. Spoken language benefits of extending cochlear implant candidacy below 12 months of age. Otol Neurotol 2013; 34:532-8. [PMID: 23478647 PMCID: PMC3600165 DOI: 10.1097/mao.0b013e318281e215] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To test the hypothesis that cochlear implantation surgery before 12 months of age yields better spoken language results than surgery between 12 and 18 months of age. STUDY DESIGN Language testing administered to children at 4.5 years of age (± 2 mo). SETTING Schools, speech-language therapy offices, and cochlear implant (CI) centers in the United States and Canada. PARTICIPANTS Sixty-nine children who received a cochlear implant between ages 6 and 18 months of age. All children were learning to communicate via listening and spoken language in English-speaking families. MAIN OUTCOME MEASURE Standard scores on receptive vocabulary, expressive, and receptive language (includes grammar). RESULTS Children with CI surgery at 6 to 11 months (n = 27) achieved higher scores on all measures as compared with those with surgery at 12 to 18 months (n = 42). Regression analysis revealed a linear relationship between age of implantation and language outcomes throughout the 6- to 18-month surgery-age range. CONCLUSION For children in intervention programs emphasizing listening and spoken language, cochlear implantation before 12 months of age seems to provide a significant advantage for spoken language achievement observed at 4.5 years of age.
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Affiliation(s)
- Johanna G Nicholas
- Department of Otolaryngology-Head and NeckSurgery, Campus Box 8115, Washington University School of Medicine, 660 S. Euclid Avenue, St. Louis, MO 63110, USA.
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168
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Geers AE, Nicholas JG. Enduring advantages of early cochlear implantation for spoken language development. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2013; 56:643-55. [PMID: 23275406 PMCID: PMC3654086 DOI: 10.1044/1092-4388(2012/11-0347)] [Citation(s) in RCA: 129] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
PURPOSE In this article, the authors sought to determine whether the precise age of implantation (AOI) remains an important predictor of spoken language outcomes in later childhood for those who received a cochlear implant (CI) between 12 and 38 months of age. Relative advantages of receiving a bilateral CI after age 4.5 years, better pre-CI-aided hearing, and longer CI experience were also examined. METHOD Sixty children participated in a prospective longitudinal study of outcomes at 4.5 and 10.5 years of age. Twenty-nine children received a sequential second CI. Test scores were compared with normative samples of hearing age mates, and predictors of outcomes were identified. RESULTS Standard scores on language tests at 10.5 years of age remained significantly correlated with age of first cochlear implantation. Scores were not associated with receipt of a second, sequentially acquired CI. Significantly higher scores were achieved for vocabulary as compared with overall language, a finding not evident when the children were tested at younger ages. CONCLUSION Age-appropriate spoken language skills continued to be more likely with younger AOI, even after an average of 8.6 years of additional CI use. Receipt of a second implant between ages 4 and 10 years and longer duration of device use did not provide significant added benefit.
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169
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Walker EA, McGregor KK. Word learning processes in children with cochlear implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2013; 56:375-87. [PMID: 22896047 PMCID: PMC3578980 DOI: 10.1044/1092-4388(2012/11-0343)] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
PURPOSE To determine whether 3 aspects of the word learning process-fast mapping, retention, and extension-are problematic for children with cochlear implants (CIs). METHOD The authors compared responses of 24 children with CIs, 24 age-matched hearing children, and 23 vocabulary-matched hearing children to a novel object noun training episode. Comprehension and production were measured immediately following training (fast mapping) as well as 1 day later (retention). Extension was measured in terms of the ability of the participants to identify new (untrained) exemplars. RESULTS Compared with their hearing age-mates, children with CIs performed marginally more poorly on fast mapping as measured by the comprehension probe and more poorly on retention as measured by comprehension and production probes. The age-mates improved over the retention interval, but the children with CIs did not. Most of the children with CIs performed similarly to their age-mates on extension, but 2 children underextended, and 5 children failed to understand the task. Compared with younger vocabulary-matched peers, children with CIs did not differ at fast mapping, retention, or extension. CONCLUSIONS Children with CIs demonstrated deficits in word learning, with retention being especially problematic. Their learning did not differ from that of younger children with similarly sized vocabularies.
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Kumar S, Rout N, Kumar N, Chatterjee I, Selvakumaran H. Performance of Indian Children with Cochlear Implant on PEACH Scale. ISRN OTOLARYNGOLOGY 2013; 2013:565096. [PMID: 23724276 PMCID: PMC3658423 DOI: 10.1155/2013/565096] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 01/19/2013] [Indexed: 11/18/2022]
Abstract
This study compares the functional language performance of Tamil-speaking children (n = 30) who received a cochlear implant (CI) before 2 years of age (earlier implanted group: EIG) and between 3 and 4 years of age (later implanted group: LIG). Everyday functional language of children was evaluated by interviewing parents using the adapted Parents' Evaluation of Aural/Oral Performance of Children (PEACH) Questionnaire in Tamil language. On average, both groups of children had difficulties in everyday language functioning. However, functional results of EIG were better than those of LIG. In addition significant correlations were found between age at intervention and PEACH score. The evidence lends support to early intervention increasing the functional performance of the children fitted with CI. PEACH can be a clinically feasible evaluation tool to implement in practice for clinicians to obtain meaningful information regarding children's auditory performance in real life at childhood.
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Affiliation(s)
- Suman Kumar
- Department of Speech and Hearing, ERC, AYJNIHH, B.T. Road, Bon Hooghly, Kolkata 700090, India
| | - Nachiketa Rout
- NIEPMD, East Coast Road, Kovalam Post, Muttukadu, Tamil Nadu, Chennai 603112, India
| | - Navnit Kumar
- All India Institute of Speech & Hearing (AIISH), Manasagangothri, Mysore 57000, India
| | - Indranil Chatterjee
- Department of Speech and Hearing, ERC, AYJNIHH, B.T. Road, Bon Hooghly, Kolkata 700090, India
| | - H. Selvakumaran
- Astra Hearing Care Centre, Unit No. 5, Iswarya Laxmi Plaza, K. K. Nagar, Tamil Nadu, Madurai 625020, India
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171
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Tribushinina E, Gillis S, De Maeyer S. Infrequent word classes in the speech of two- to seven-year-old children with cochlear implants and their normally hearing peers: a longitudinal study of adjective use. Int J Pediatr Otorhinolaryngol 2013; 77:356-61. [PMID: 23245493 DOI: 10.1016/j.ijporl.2012.11.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 11/10/2012] [Accepted: 11/17/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Studies investigating language skills of children after cochlear implantation usually use global language proficiency scores and rarely tackle the acquisition of specific language phenomena (word classes, grammatical constructions, etc.). Furthermore, research is largely restricted to frequent word classes (nouns, verbs). The present study targets the acquisition of adjectives (e.g. big, intelligent) by children implanted before their second birthday. Adjectives constitute a relatively infrequent, but functionally important word class and were shown to be good indicators of language delays and impairments. METHOD Nine cochlear-implanted (CI) children and 60 age-matched normally hearing (NH) controls participated in the study. The CI children were followed longitudinally from ages 2 to 7; control data were collected in a cross-sectional manner (10 children per age group). Samples of children's spontaneous interactions with their caregivers were transcribed and analyzed for adjective use (frequency, lexical diversity, complexity of syntactic constructions, and morphological correctness). RESULTS The performance of the CI subjects was not significantly different from that of NH peers on adjective frequency and lexical diversity. On these measures, both groups reached adult levels by age 3. However, the CI group had a significant delay in the acquisition of complex syntactic constructions. The NH subjects produced adjectives in adult-like grammatical constructions from age 3 onwards, whereas their CI peers lagged behind until age 5. The speech of the CI participants also featured morphological errors that are not characteristic of typical development (inflection of predicative adjectives). However, the overall error rate was low. CONCLUSIONS The findings suggest that CI children have particular difficulty with grammatical items (bound morphemes, copulas) that are less salient in the flow of speech than content words. Nevertheless, children implanted before their second birthday are able to catch up with their hearing peers by age 5, even in the use of relatively infrequent word classes.
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Affiliation(s)
- Elena Tribushinina
- Utrecht Institute of Linguistics, Utrecht University, Trans 10, 3512 JK Utrecht, The Netherlands.
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172
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Tobey EA, Thal D, Niparko JK, Eisenberg LS, Quittner AL, Wang NY. Influence of implantation age on school-age language performance in pediatric cochlear implant users. Int J Audiol 2013; 52:219-29. [PMID: 23448124 DOI: 10.3109/14992027.2012.759666] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study examined specific spoken language abilities of 160 children with severe-to-profound sensorineural hearing loss followed prospectively 4, 5, or 6 years after cochlear implantation. STUDY SAMPLE Ninety-eight children received implants before 2.5 years, and 62 children received implants between 2.5 and 5 years of age. DESIGN Language was assessed using four subtests of the Comprehensive Assessment of Spoken Language (CASL). Standard scores were evaluated by contrasting age of implantation and follow-up test time. RESULTS Children implanted under 2.5 years of age achieved higher standard scores than children with older ages of implantation for expressive vocabulary, expressive syntax, and pragmatic judgments. However, in both groups, some children performed more than two standard deviations below the standardization group mean, while some scored at or well above the mean. CONCLUSIONS Younger ages of implantation are associated with higher levels of performance, while later ages of implantation are associated with higher probabilities of continued language delays, particularly within subdomains of grammar and pragmatics. Longitudinal data from this cohort study demonstrate that after 6 years of implant experience, there is large variability in language outcomes associated with modifiers of rates of language learning that differ as children with implants age.
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Affiliation(s)
- Emily A Tobey
- Dallas Cochlear Implant Program, University of Texas at Dallas, Dallas, Texas, USA.
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173
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Faulkner KF, Pisoni DB. Some observations about cochlear implants: challenges and future directions. ACTA ACUST UNITED AC 2013. [DOI: 10.7243/2052-6946-1-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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174
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[Assessing language development in children with cochlear implants using the parental questionnaire FRAKIS]. HNO 2012; 61:404-8. [PMID: 23241867 DOI: 10.1007/s00106-012-2631-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The aim of this study was to examine if the parental questionnaire FRAKIS (German CDI questionnaire on early language development) is a valid instrument for assessing linguistic progress in children with cochlear implants (CI). Descriptive statistics on the course of language acquisition in children with CI will also be presented. MATERIALS AND METHODS Participants were 140 children with CI and language levels were assessed cross-sectionally with the parental questionnaire FRAKIS at 12, 18, 24 and 30 months post-implantation. For a subgroup of 25 children language was assessed longitudinally and additionally by 45 min spontaneous speech samples per data point. RESULTS Correlational analyses showed high concurrent validity between the questionnaire measures of vocabulary, inflectional morphology, sentence complexity, as well as the subscales of inflectional morphology and the corresponding language measures based on spontaneous speech. Descriptive statistics for the course of language development indicated a wide distribution of children across language levels. CONCLUSIONS The parental questionnaire FRAKIS is a valid instrument for assessing language levels in children with CI. In assessing these children it is recommended that they are compared with values within this population.
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175
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Szagun G, Stumper B. Age or experience? The influence of age at implantation and social and linguistic environment on language development in children with cochlear implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2012; 55:1640-54. [PMID: 22490622 DOI: 10.1044/1092-4388(2012/11-0119)] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE The authors investigated the influence of social environmental variables and age at implantation on language development in children with cochlear implants. METHOD Participants were 25 children with cochlear implants and their parents. Age at implantation ranged from 6 months to 42 months ( M (age) = 20.4 months, SD = 22.0 months). Linguistic progress was assessed at 12, 18, 24, and 30 months after implantation. At each data point, language measures were based on parental questionnaire and 45-min spontaneous speech samples. Children's language and parents' child-directed language were analyzed. RESULTS On all language measures, children displayed considerable vocabulary and grammatical growth over time. Although there was no overall effect of age at implantation, younger and older children had different growth patterns. Children implanted by age 24 months made the most marked progress earlier on, whereas children implanted thereafter did so later on. Higher levels of maternal education were associated with faster linguistic progress; age at implantation was not. Properties of maternal language input, mean length of utterance, and expansions were associated with children's linguistic progress independently of age at implantation. CONCLUSIONS In children implanted within the sensitive period for language learning, children's home language environment contributes more crucially to their linguistic progress than does age at implantation.
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176
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Fulcher A, Purcell AA, Baker E, Munro N. Listen up: children with early identified hearing loss achieve age-appropriate speech/language outcomes by 3 years-of-age. Int J Pediatr Otorhinolaryngol 2012; 76:1785-94. [PMID: 23084781 DOI: 10.1016/j.ijporl.2012.09.001] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 08/23/2012] [Accepted: 09/03/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Age-appropriate speech/language outcomes for children with early identified hearing loss are a possibility but not a certainty. Identification of children most likely to achieve optimal outcomes is complicated by the heterogeneity of the children involved in outcome research, who present with a range of malleable (e.g. age of identification and cochlear implantation, type of intervention, communication mode) and non-malleable (e.g. degree of hearing loss) factors. This study considered whether a homogenous cohort of early identified children (≤ 12 months), with all severities of hearing loss and no other concomitant diagnoses could not only significantly outperform a similarly homogenous cohort of children who were later identified (>12 months to <5 years), but also achieve and maintain age-appropriate speech/language outcomes by 3, 4 and 5 years of age. METHODS A mixed prospective/retrospective comparative study of a homogenous cohort of 45 early identified (≤ 12 months) and 49 late identified (> 12 months to < 5 years) children with hearing loss was conducted. The children all attended the same oral auditory-verbal early intervention programme. Speech/language assessments standardized on typically developing hearing children were conducted at 3, 4 and 5 years of age. RESULTS The early identified children significantly outperformed the late identified at all ages and for all severities of HL. By 3 years of age, 93% of all early identified participants scored within normal limits (WNL) for speech; 90% were WNL for understanding vocabulary; and 95% were WNL for receptive and expressive language. Progress was maintained and improved so that by 5 years of age, 96% were WNL for speech, with 100% WNL for language. CONCLUSIONS This study found that most children with all severities of hearing loss and no other concomitant diagnosed condition, who were early diagnosed; received amplification by 3 months; enrolled into AV intervention by 6 months and received a cochlear implant by 18 months if required, were able to "keep up with" rather than "catch up to" their typically hearing peers by 3 years of age on measures of speech and language, including children with profound hearing loss. By 5 years, all children achieved typical language development and 96% typical speech.
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177
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Kopecky B, Fritzsch B. The myc road to hearing restoration. Cells 2012; 1:667-98. [PMID: 24710525 PMCID: PMC3901154 DOI: 10.3390/cells1040667] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 08/12/2012] [Accepted: 09/14/2012] [Indexed: 01/01/2023] Open
Abstract
Current treatments for hearing loss, the most common neurosensory disorder, do not restore perfect hearing. Regeneration of lost organ of Corti hair cells through forced cell cycle re-entry of supporting cells or through manipulation of stem cells, both avenues towards a permanent cure, require a more complete understanding of normal inner ear development, specifically the balance of proliferation and differentiation required to form and to maintain hair cells. Direct successful alterations to the cell cycle result in cell death whereas regulation of upstream genes is insufficient to permanently alter cell cycle dynamics. The Myc gene family is uniquely situated to synergize upstream pathways into downstream cell cycle control. There are three Mycs that are embedded within the Myc/Max/Mad network to regulate proliferation. The function of the two ear expressed Mycs, N-Myc and L-Myc were unknown less than two years ago and their therapeutic potentials remain speculative. In this review, we discuss the roles the Mycs play in the body and what led us to choose them to be our candidate gene for inner ear therapies. We will summarize the recently published work describing the early and late effects of N-Myc and L-Myc on hair cell formation and maintenance. Lastly, we detail the translational significance of our findings and what future work must be performed to make the ultimate hearing aid: the regeneration of the organ of Corti.
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Affiliation(s)
- Benjamin Kopecky
- Department of Biology, 143 Biology Building, University of Iowa, Iowa City, IA 52242, USA.
| | - Bernd Fritzsch
- Department of Biology, 143 Biology Building, University of Iowa, Iowa City, IA 52242, USA.
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178
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Cruz I, Quittner AL, Marker C, DesJardin JL. Identification of effective strategies to promote language in deaf children with cochlear implants. Child Dev 2012; 84:543-59. [PMID: 23002910 DOI: 10.1111/j.1467-8624.2012.01863.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Parental involvement and communication are essential for language development in young children. However, hearing parents of deaf children face challenges in providing language input to their children. This study utilized the largest national sample of deaf children receiving cochlear implants, with the aim of identifying effective facilitative language techniques. Ninety-three deaf children (≤ 2 years) were assessed at 6 implant centers prior to and for 3 years following implantation. All parent-child interactions were videotaped, transcribed, and coded at each assessment. Analyses using bivariate latent difference score modeling indicated that higher versus lower level strategies predicted growth in expressive language and word types predicted growth in receptive language over time. These effective, higher level strategies could be used in early intervention programs.
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Affiliation(s)
- Ivette Cruz
- Department of Otolaryngology, University of Miami, Miami, FL 33136, USA.
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179
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Cardon G, Campbell J, Sharma A. Plasticity in the developing auditory cortex: evidence from children with sensorineural hearing loss and auditory neuropathy spectrum disorder. J Am Acad Audiol 2012; 23:396-411; quiz 495. [PMID: 22668761 DOI: 10.3766/jaaa.23.6.3] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The developing auditory cortex is highly plastic. As such, the cortex is both primed to mature normally and at risk for reorganizing abnormally, depending upon numerous factors that determine central maturation. From a clinical perspective, at least two major components of development can be manipulated: (1) input to the cortex and (2) the timing of cortical input. Children with sensorineural hearing loss (SNHL) and auditory neuropathy spectrum disorder (ANSD) have provided a model of early deprivation of sensory input to the cortex and demonstrated the resulting plasticity and development that can occur upon introduction of stimulation. In this article, we review several fundamental principles of cortical development and plasticity and discuss the clinical applications in children with SNHL and ANSD who receive intervention with hearing aids and/or cochlear implants.
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Affiliation(s)
- Garrett Cardon
- Speech, Language and Hearing Sciences Department, University of Colorado at Boulder, Boulder, CO 80309, USA
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180
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Tobey EA, Britt L, Geers A, Loizou P, Loy B, Roland P, Warner-Czyz A, Wright CG. Cochlear implantation updates: the Dallas Cochlear Implant Program. J Am Acad Audiol 2012; 23:438-45. [PMID: 22668764 DOI: 10.3766/jaaa.23.6.6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This report provides an overview of many research projects conducted by the Dallas Cochlear Implant Program, a joint enterprise between the University of Texas at Dallas, the University of Texas Southwestern Medical Center, and Children's Medical Center. The studies extend our knowledge of factors influencing communication outcomes in users of cochlear implants. Multiple designs and statistical techniques are used in the studies described including both cross sectional and longitudinal analyses. Sample sizes vary across the studies, and many of the samples represent large populations of children from North America. Multiple statistical techniques are used by the team to analyze outcomes. The team has provided critical information regarding electrode placement, signal processing, and communication outcomes in users of cochlear implants.
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Affiliation(s)
- Emily A Tobey
- Dallas Cochlear Implant Program, Dallas, TX 75235, USA.
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181
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Abstract
Over the past 30 years, hearing care clinicians have increasingly relied on cochlear implants to restore auditory sensitivity in selected patients with advanced sensorineural hearing loss. This article examines the impact of intervention with cochlear implantation in children and adults. The authors report a range of clinic-based results and patient-based outcomes reflected in the reported literature on cochlear implants. The authors describe the basic assessment of the physiologic response to auditory nerve stimulation; measures of receptive and productive benefit; and surveys of life effects as reflected measures of quality of life, educational attainment, and economic impact.
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182
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Silva MPD, Comerlatto Junior AA, Bevilacqua MC, Lopes-Herrera SA. Instruments to assess the oral language of children fitted with a cochlear implant: a systematic review. J Appl Oral Sci 2012; 19:549-53. [PMID: 22230986 PMCID: PMC3973453 DOI: 10.1590/s1678-77572011000600002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Accepted: 08/16/2011] [Indexed: 12/02/2022] Open
Abstract
The oral language development depends on the effective development of the hearing
system. In cases of children presenting with hearing loss, a cochlear implant is an
electronic device indicated to (re)habilitate the hearing function. Thus, it is of
paramount importance to assess and follow the oral language development of children
fitted with a cochlear implant (CI) to measure the effectiveness of the electronic
device and support the therapeutic planning of these children. Questions are
currently being raised about the instruments to assess the oral language of children
using a CI, and, seeking the answers, this systematic review aimed at surveying these
instruments. Searches were performed in three different databases utilizing six
different descriptors to select articles published from 2004 to 2009 that performed
an oral language assessment of children with a CI. Initially, 373 articles were
found, and, after the application of inclusion criteria, 47 articles were analyzed,
resulting in a survey of 74 instruments for oral language assessment, including
tests, questionnaires and inventories. In analyzing the articles, it was realized
that the studies included in this systematic review presented varied methodologies
and low levels of evidence, with a greater concentration of instruments assessing
receptive and expressive language, emphasizing the survey of the child's vocabulary
and questionnaires. Thus, it can be verified that other linguistic skills, such as
morphosyntactic, semantic, and narrative-pragmatic ones that are important in
structuring speech and language for the effectiveness of the child's speech, are not
being focused on. Just one of the instruments cited, a questionnaire, was specific
for the oral language assessment of children with cochlear implants.
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183
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Coppens KM, Tellings A, van der Veld W, Schreuder R, Verhoeven L. Vocabulary development in children with hearing loss: the role of child, family, and educational variables. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:119-128. [PMID: 22093656 DOI: 10.1016/j.ridd.2011.08.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 08/30/2011] [Indexed: 05/31/2023]
Abstract
In the present study we examined the effect of hearing status on reading vocabulary development. More specifically, we examined the change of lexical competence in children with hearing loss over grade 4-7 and the predictors of this change. Therefore, we used a multi-factor longitudinal design with multiple outcomes, measuring the reading vocabulary knowledge in children with hearing loss from grades 4 and 5, and of children without hearing loss from grade 4, for 3 years with two word tasks: a lexical decision task and a use decision task. With these tasks we measured word form recognition and (in)correct usage recognition, respectively. A GLM repeated measures procedure indicated that scores and growth rates on the two tasks were affected by hearing status. Moreover, with structural equation modeling we observed that the development of lexical competence in children with hearing loss is stable over time, and a child's lexical competence can be explained best by his or her lexical competence assessed on a previous measurement occasion. If you look back, differences in lexical competence among children with hearing loss stay unfortunately the same. Educational placement, use of sign language at home, intelligence, use of hearing devices, and onset of deafness can account for the differences among children with hearing loss.
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Affiliation(s)
- Karien M Coppens
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.
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184
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Hyde M, Punch R, Grimbeek P. Factors predicting functional outcomes of cochlear implants in children. Cochlear Implants Int 2011; 12:94-104. [PMID: 21756502 DOI: 10.1179/146701010x12677899497317] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This article reports the relationships between a large number of child- and family-related factors and children's functional outcomes, according to parental report, in the domains of spoken language communication, social skills and participation, academic achievement, and independence and identity, through a series of stepwise regression analyses. Parents of 247 children who had received cochlear implants in three eastern states of Australia completed a survey on their expectations and experiences of their children's outcomes with cochlear implants. A number of the independent variables were found to be associated, either positively or negatively, with children's outcomes. Implications for cochlear implant professionals, early intervention programmes, and educational authorities are discussed.
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Affiliation(s)
- Merv Hyde
- University of the Sunshine Coast, Queensland, Australia
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185
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Communication, psychosocial, and educational outcomes of children with cochlear implants and challenges remaining for professionals and parents. Int J Otolaryngol 2011; 2011:573280. [PMID: 21904554 PMCID: PMC3167182 DOI: 10.1155/2011/573280] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2011] [Accepted: 06/16/2011] [Indexed: 12/30/2022] Open
Abstract
This paper provides an overview and a synthesis of the findings of a large, multifaceted study investigating outcomes from paediatric cochlear implantation. The study included children implanted at several Australian implant clinics and attending a variety of early intervention and educational settings across a range of locations in eastern Australia. It investigated three major aspects of childhood cochlear implantation: (1) parental expectations of their children's implantation, (2) families' decision-making processes, and (3) the communication, social, and educational outcomes of cochlear implantation for deaf children. It employed a mixed-methods approach in which quantitative survey data were gathered from 247 parents and 151 teachers, and qualitative data from semistructured interviews with 27 parents, 15 teachers, and 11 children and adolescents with cochlear implants. The summarised findings highlight several areas where challenges remain for implant clinics, parents, and educators if children with cochlear implants are to reach their full potential personally, educationally, and socially.
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186
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Grugel L, Streicher B, Lang-Roth R, Walger M, Meister H. Measuring communicative performance with the German version of the FAPCI-instrument: normative data and longitudinal results. Int J Pediatr Otorhinolaryngol 2011; 75:543-8. [PMID: 21296429 DOI: 10.1016/j.ijporl.2011.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Revised: 12/21/2010] [Accepted: 01/10/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The German version of the Functioning after Paediatric Cochlear Implantation (FAPCI) inventory was designed to capture the communicative performance of cochlear implanted children. In order to be able to compare cochlear-implanted children to their normal hearing peers, normative growth curves were designed. Furthermore it was of interest how the communicative performance develops over time and whether it is influenced by age at implantation. METHOD A polynomial regression curve was fit to the data of 133 normal hearing children. This normative curve was compared to individual growth curves of 90 cochlear implanted children. The cochlear-implanted study sample was split up into four groups depending on the age at implantation. RESULTS The normative growth curve increases from 1 year of age until saturation is reached with 3 years of age. The individual FAPCI trajectories of cochlear implanted children are heterogeneous, but in general they are delayed in comparison to the normative growth curve. "Early implanted children" follow the development of their normal hearing peers more closely than "later-implanted children". CONCLUSION The German version of the FAPCI parental questionnaire constitutes an additional instrument in monitoring the communicative performance development of cochlear implanted children and allows for comparison to normal hearing peers.
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Affiliation(s)
- Linda Grugel
- Jean-Uhrmacher-Institute for Clinical ENT Research, University of Cologne, Germany.
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187
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Moog JS, Geers AE, Gustus CH, Brenner CA. Psychosocial adjustment in adolescents who have used cochlear implants since preschool. Ear Hear 2011; 32:75S-83S. [PMID: 21832891 PMCID: PMC3160727 DOI: 10.1097/aud.0b013e3182014c76] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study examined psychosocial characteristics of students who had used a cochlear implant (CI) since preschool and were evaluated when they were in elementary grades and again in high school. The study had four goals: (1) to determine the extent to which psychosocial skills documented in elementary grades were maintained into high school; (2) to assess the extent to which long-term CI users identified with the Deaf community or the hearing world or both; (3) to examine the association between group identification and the student's sense of self-esteem, preferred communication mode, and spoken language skills; and (4) to describe the extracurricular world of the teenagers who were mainstreamed with hearing age-mates for most of their academic experience. DESIGN As part of a larger study, 112 CI students (aged 15.0 to 18.6 yrs) or their parents completed questionnaires describing their social skills, and a subsample of 107 CI students completed group identification and self-esteem questionnaires. Results were compared with either a control group of hearing teenagers (N = 46) or age-appropriate hearing norms provided by the assessment developer. RESULTS Average psychosocial ratings from both parents and students at both elementary grades and high school indicated a positive self-image throughout the school years. Seventy percent of the adolescents expressed either strong identification with the hearing community (32%) or mixed identification with both deaf and hearing communities (38%). Almost all CI students (95%) were mainstreamed for more than half of the day, and the majority of students (85%) were in the appropriate grade for their age. Virtually all CI students (98%) reported having hearing friends, and a majority reported having deaf friends. More than 75% of CI students reported that they used primarily spoken language to communicate and that good spoken language skills enabled them to participate more fully in all aspects of their lives. Identification with the hearing world was not associated with personal or social adjustment problems but was associated with better speech perception and English language skill. Ninety-four percent were active participants in high school activities and sports, and 50% held part-time jobs (a rate similar to that documented for hearing teens). CONCLUSIONS The majority of these early-implanted adolescents reported strong social skills, high self-esteem, and at least mixed identification with the hearing world. However, these results must be viewed in light of possible sources of sample selection bias and may not represent the psychosocial characteristics of the entire population of children receiving CIs.
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Affiliation(s)
- Jean S Moog
- Moog Center for Deaf Education, St. Louis, Missouri 63131, USA.
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188
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Geers AE, Sedey AL. Language and verbal reasoning skills in adolescents with 10 or more years of cochlear implant experience. Ear Hear 2011; 32:39S-48S. [PMID: 21832889 PMCID: PMC3157037 DOI: 10.1097/aud.0b013e3181fa41dc] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The purpose of this study is to identify factors predictive of successful English language outcomes in adolescents who received a cochlear implant (CI) between 2 and 5 yrs of age. DESIGN All 112 participants had been part of a previous study examining English language outcomes at the age of 8 and 9 yrs with CIs. The participants were given a battery of language and verbal reasoning tests in their preferred communication mode along with measures of working memory (digit span) and verbal rehearsal speed (sentence repetition duration). The degree to which students' language performance was enhanced when sign was added to spoken language was estimated at both test sessions. Multiple linear regression analyses were used to document factors contributing to overall language outcomes. RESULTS A substantial proportion of the adolescents obtained test scores within or above 1SD compared with hearing age-mates in the tests' normative samples: 71% on a verbal intelligence test, 68% on a measure of language content, 71% on receptive vocabulary, and 74% on expressive vocabulary. Improvement in verbal intelligence scores over an 8-yr interval exceeded expectation based on age-mates in the test's normative sample. Better English language outcomes were associated with shorter duration of deafness before cochlear implantation, higher nonverbal intelligence, higher family socioeconomic status, longer digit spans, and faster verbal rehearsal speed as measured by sentence repetition rate. Students whose current receptive vocabulary scores were not enhanced by the addition of signs also exhibited higher English language scores than those without sign enhancement; however, sign enhancement demonstrated in the elementary school years was not predictive of later high-school language skills. CONCLUSIONS Results of this study support the provision of CIs to children at the youngest age possible. In addition, it highlights the substantial role that cognition plays in later language outcomes. Although the students' use of sign to enhance language skills during the elementary years does not appear to have a negative impact on later language skills, students who continue to rely on sign to improve their vocabulary comprehension into high school typically exhibit poorer English language outcomes than students whose spoken language comprehension parallels or exceeds their comprehension of speech + sign. Overall, the language results obtained from these teenagers with more than 10 yrs of CI experience reflect substantial improvement over the verbal skills exhibited by adolescents with similar levels of hearing loss before the advent of CIs. These optimistic results were observed in teenagers who were among the first in the United States and Canada to receive a CI. We anticipate that the use of improved technology that is being initiated at even younger ages should lead to age-appropriate language levels in an even larger proportion of children with CIs.
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Affiliation(s)
- Ann E Geers
- Dallas Cochlear Implant Program, Callier Advanced Hearing Research Center, University of Texas at Dallas, Dallas, Texas 75235, USA.
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Describing the trajectory of language development in the presence of severe-to-profound hearing loss: a closer look at children with cochlear implants versus hearing aids. Otol Neurotol 2011; 31:1268-74. [PMID: 20818291 DOI: 10.1097/mao.0b013e3181f1ce07] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this investigation was to describe the language growth of children with severe or profound hearing loss with cochlear implants versus those children with the same degree of hearing loss using hearing aids. STUDY DESIGN A prospective longitudinal observation and analysis. SETTING University of Colorado Department of Speech Language and Hearing Sciences. PATIENTS There were 87 children with severe-to-profound hearing loss from 48 to 87 months of age. INTERVENTION All children received early intervention services through the Colorado Home Intervention Program. Most children received intervention services from a certified auditory-verbal therapist or an auditory-oral therapist and weekly sign language instruction from an instructor who was deaf or hard of hearing and native or fluent in American Sign Language. MAIN OUTCOME MEASURES The Test of Auditory Comprehension of Language, 3rd Edition, and the Expressive One Word Picture Vocabulary Test, 3rd Edition, were the assessment tools for children 4 to 7 years of age. The expressive language subscale of the Minnesota Child Development was used in the infant/toddler period (birth to 36 mo). RESULTS Average language estimates at 84 months of age were nearly identical to the normative sample for receptive language and 7 months delayed for expressive vocabulary. Children demonstrated a mean rate of growth from 4 years through 7 years on these 2 assessments that was equivalent to their normal-hearing peers. As a group, children with hearing aids deviated more from the age equivalent trajectory on the Test of Auditory Comprehension of Language, 3rd Edition, and the Expressive One Word Picture Vocabulary Test, 3rd Edition, than children with cochlear implants. When a subset of children were divided into performance categories, we found that children with cochlear implants were more likely to be "gap closers" and less likely to be "gap openers," whereas the reverse was true for the children with hearing aids for both measures. CONCLUSION Children who are educated through oral-aural combined with sign language instruction can achieve age-appropriate language levels on expressive vocabulary and receptive syntax ages 4 through 7 years. However, it is easier to maintain a constant rate of development rather than to accelerate from birth through 84 months of age, which represented approximately 80% of our sample. However, acceleration of language development is possible in some children and could result from cochlear implantation.
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190
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Wu CM, Chen YA, Chan KC, Lee LA, Hsu KH, Lin BG, Liu TC. Long-term language levels and reading skills in mandarin-speaking prelingually deaf children with cochlear implants. Audiol Neurootol 2010; 16:359-80. [PMID: 21196727 DOI: 10.1159/000322310] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Accepted: 10/15/2010] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to document receptive and expressive language levels and reading skills achieved by Mandarin-speaking children who had received cochlear implants (CIs) and used them for 4.75-7.42 years. The effects of possible associated factors were also analyzed. Standardized Mandarin language and reading tests were administered to 39 prelingually deaf children with Nucleus 24 devices. The Mandarin Chinese version of the Peabody Picture Vocabulary Test was used to assess their receptive vocabulary knowledge and the Revised Primary School Language Assessment Test for their receptive and expressive language skills. The Graded Chinese Character Recognition Test was used to test their written word recognition ability and the Reading Comprehension Test for their reading comprehension ability. Raw scores from both language and reading measurements were compared to normative data of nor- mal-hearing children to obtain standard scores. The results showed that the mean standard score for receptive vocabulary measurement and the mean T scores for the receptive language, expressive language and total language measurement were all in the low-average range in comparison to the normative sample. In contrast, the mean T scores for word and text reading comprehension were almost the same as for their age-matched hearing counterparts. Among all children with CIs, 75.7% scored within or above the normal range of their age-matched hearing peers on receptive vocabulary measurement. For total language, Chinese word recognition and reading scores, 71.8, 77 and 82% of children with CIs were age appropriate, respectively. A strong correlation was found between language and reading skills. Age at implantation and sentence perception scores account for 37% of variance for total language outcome. Sentence perception scores and preimplantation residual hearing were revealed to be associated with the outcome of reading comprehension. We concluded that by using standard tests, the language development and reading skill of Mandarin-speaking children who use CIs from a young age appear to fall within the normal range of their hearing age mates, at least after 4.8-7.4 years of experience. However, to fully evaluate the fine linguistic skills of these subjects, a more detailed study and longer follow-up period are needed.
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Affiliation(s)
- Che-Ming Wu
- Department of Otolaryngology, Chang-Gung Memorial Hospital, College of Medicine, Chang-Gung University, Linkou, Taiwan, ROC
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191
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DesJardin JL, Ambrose SE. The Importance of the Home Literacy Environment for Developing Literacy Skills in Young Children Who Are Deaf or Hard of Hearing. ACTA ACUST UNITED AC 2010. [DOI: 10.1177/1096250610387270] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Four-year-old Olivia, who is deaf and has used a cochlear implant for 3 years, and her mother, Laura, enjoy looking at storybooks together at home. During storybook reading, Laura notices that Olivia tries to imitate some words that she reads to her yet does not seem to understand many words or story events. Laura is unsure whether to stop the storybook interaction and encourage Olivia’s attempts at word imitation and directly teach her the new vocabulary or continue reading the story for pleasure. Olivia’s preschool teacher, Ms. Lynn, also notices that Olivia displays a keen interest in storybook reading but is not able to answer or ask simple questions about the story. What can Laura and Ms. Lynn do collaboratively to support Olivia’s emerging language and literacy skills to better prepare Olivia for her upcoming transition into kindergarten?
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192
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Wie OB. Language development in children after receiving bilateral cochlear implants between 5 and 18 months. Int J Pediatr Otorhinolaryngol 2010; 74:1258-66. [PMID: 20800293 DOI: 10.1016/j.ijporl.2010.07.026] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 07/03/2010] [Accepted: 07/30/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The objective of this study was to examine receptive and expressive language development in children who received simultaneous bilateral cochlear implants (CIs) between 5 and 18 months of age and to compare the results with language development in chronologically age-matched children with normal hearing. METHODS The study used a prospective, longitudinal matched-group design. Data were collected in a clinical setting at postoperative cochlear implant check-ups after 3, 6, 9, 12, 18, 24, 36, and 48 months of implant use. The sample included 42 children: 21 cochlear implant users and 21 with normal hearing, matched pairwise according to gender and chronological age. Communication assessments included the LittlEARS questionnaire, the Mullen Scale of Early Learning, and the Minnesota Child Development Inventory. RESULTS The cochlear implant users' hearing function according to LittlEARS was comparable to that of normal-hearing children within 9 months post-implantation. The mean scores after 9 and 12 months were 31 and 33, respectively in the prelingually deaf versus 31 and 34 in the normal-hearing children. The children's receptive and expressive language scores showed that after 12-48 months with cochlear implants, 81% had receptive language skills within the normative range and 57% had expressive language skills within the normative range. The number of children who scored within the normal range increased with increasing CI experience. CONCLUSIONS The present study showed that prelingually deaf children's ability to develop complex expressive and receptive spoken language after early bilateral implantation appears promising. The majority of the children developed language skills at a faster pace than their hearing ages would suggest and over time achieved expressive and receptive language skills within the normative range.
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Affiliation(s)
- Ona B Wie
- Department of Otolaryngology, Oslo University Hospital, 0027 Rikshospitalet, Norway.
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193
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Affiliation(s)
- Andrej Kral
- Institute of Audioneurotechnology and the Department of Experimental Otology, Ear, Nose, and Throat Clinics, Medical University Hannover, Hannover, Germany.
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194
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Early Educational Placement and Later Language Outcomes for Children With Cochlear Implants. Otol Neurotol 2010; 31:1315-9. [DOI: 10.1097/mao.0b013e3181eb3226] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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195
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Moreno-Torres I, Torres S, Santana R. Lexical and grammatical development in a child with cochlear implant and attention deficit: A case study. CLINICAL LINGUISTICS & PHONETICS 2010; 24:706-721. [PMID: 20645855 DOI: 10.3109/02699206.2010.488782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This is the first study to explore lexical and grammatical development in a deaf child diagnosed with Attention Deficit Hyperactivity Disorder, Inattentive sub-type (ADHD/I). The child, whose family language was Spanish, was fitted with a cochlear implant (CI) when she was 18 months old. ADHD/I, for which she was prescribed medication, was diagnosed 3;6 years later. Speech samples were videotaped over the first 4 years of CI use and during a follow-up session 1 year later. Samples were transcribed according to CHAT conventions and several measures of expressive language were obtained. Receptive language was evaluated with standardized tests. Results show that while some aspects of her development seemed relatively positive (e.g., acquisition of verbal morphemes at the same auditory age as typical children), other characteristics were atypical for a CI user: (1) preference for paralexical expressions in early lexicon; (2) lexical errors in colours and other abstract words; and (3) low MLU and varied grammatical errors including disorganized discourse. Medication had a positive effect on all these characteristics, providing evidence of a link with ADHD/I. This study concludes that ADHD/I had a direct impact on the lexical and grammatical development in this child, as well as an indirect influence over her communicative style. More studies are needed to explore language characteristics of children with CI and ADHD.
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Martin D, Bat-Chava Y, Lalwani A, Waltzman SB. Peer relationships of deaf children with cochlear implants: predictors of peer entry and peer interaction success. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2010; 16:108-120. [PMID: 20805230 DOI: 10.1093/deafed/enq037] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This study investigated factors that affect the development of positive peer relationships among deaf children with cochlear implants. Ten 5- to 6-year-old deaf children with implants were observed under conditions varying peer context difficulty in a Peer Entry task. Results revealed better outcomes for deaf children interacting in one-on-one situations compared to interactions including two other hearing children and better performance among girls than boys. In addition, longer duration of implant use and higher self-esteem were associated with better performance on the Peer Task, which was in turn related to parental reports of children's social functioning outside the experimental situation. These findings contribute to the growing literature describing the benefits of cochlear implantation in the areas of communication and socialization, while pointing to interventions that may enhance deaf children's social competence.
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Affiliation(s)
- Daniela Martin
- Penn State Brandywine, 24 Yearsly Mill Road, Media, PA 19063, USA.
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Mellon NK, Ouellette M, Greer T, Gates-Ulanet P. Achieving developmental synchrony in young children with hearing loss. Trends Amplif 2010; 13:223-40. [PMID: 20150187 DOI: 10.1177/1084713809356701] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Children with hearing loss, with early and appropriate amplification and intervention, demonstrate gains in speech, language, and literacy skills. Despite these improvements many children continue to exhibit disturbances in cognitive, behavioral, and emotional control, self-regulation, and aspects of executive function. Given the complexity of developmental learning, educational settings should provide services that foster the growth of skills across multiple dimensions. Transdisciplinary intervention services that target the domains of language, communication, psychosocial functioning, motor, and cognitive development can promote academic and social success. Educational programs must provide children with access to the full range of basic skills necessary for academic and social achievement. In addition to an integrated curriculum that nurtures speech, language, and literacy development, innovations in the areas of auditory perception, social emotional learning, motor development, and vestibular function can enhance student outcomes. Through ongoing evaluation and modification, clearly articulated curricular approaches can serve as a model for early intervention and special education programs. The purpose of this article is to propose an intervention model that combines best practices from a variety of disciplines that affect developmental outcomes for young children with hearing loss, along with specific strategies and approaches that may help to promote optimal development across domains. Access to typically developing peers who model age-appropriate skills in language and behavior, small class sizes, a co-teaching model, and a social constructivist perspective of teaching and learning, are among the key elements of the model.
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Affiliation(s)
- Nancy K Mellon
- The River School, 4880 MacArthur Boulevard NW, Washington, DC 20007, USA.
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198
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Loy B, Warner-Czyz AD, Tong L, Tobey EA, Roland PS. The children speak: an examination of the quality of life of pediatric cochlear implant users. Otolaryngol Head Neck Surg 2010; 142:247-53. [PMID: 20115983 DOI: 10.1016/j.otohns.2009.10.045] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Revised: 10/09/2009] [Accepted: 10/27/2009] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To examine the results of health-related quality-of-life questionnaire scores from profoundly deaf children fitted with at least one cochlear implant (CI) and to compare their responses with those of normal-hearing mates of similar age and their parents. STUDY DESIGN Cross-sectional study utilizing a generic quality-of-life questionnaire designed to be completed by both parents and children independently of each other. SETTING Questionnaires completed at various summer camps designed for children with CIs in Texas and Colorado. SUBJECTS AND METHODS Eighty-eight families from 16 states were divided into two subgroups by age of cochlear implantation: an eight- to 11-year-old group and a 12- to 16-year-old group. The KINDL-R Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents was distributed, and CI participants completed the questionnaire independently of their participating family member. RESULTS CI users in both age groups scored similarly to their normal-hearing peers and their parents. Younger CI users scored their family domain lower compared with their normal-hearing peers. Teen CI users scored the school domain lower compared with their parents. Among CI participants, earlier implantation and longer CI use resulted in higher quality-of-life scores. CONCLUSION Children with CIs experience quality of life similar to that of normal-hearing peers. Parents are reliable reporters on the status of their child's overall quality of life.
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Affiliation(s)
- Betty Loy
- University of Texas Southwestern Medical Center, Dallas, TX; Dallas Cochlear Implant Program, 5323 Harry Hines Blvd, Dallas, TX 75390-9035, USA.
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Szagun G, Rüter M. The influence of parents’ speech on the development of spoken language in German-speaking children with cochlear implants. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s0214-4603(09)70025-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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