Reading instead of reasoning? Predictors of arithmetic skills in children with cochlear implants

Verbal, Figural, and Arithmetic Fluency of Children with Cochlear Implants

Cochlear implantation gives children with prelingual severe hearing loss and deafness the opportunity to develop their hearing abilities, speech, language, cognitive abilities and academic skills with adequate rehabilitation. The aim of the research was to analyze verbal, figural and arithmetic fluency and their interrelationship in children with a cochlear implant (CI) and children with normal hearing (NH). A total of 46 children with CI and 110 children with NH, aged 9 to 16, participated in the research. Verbal fluency was assessed using phonemic and semantic fluency, and non-verbal fluency using figural fluency. Arithmetic fluency was assessed using simple arithmetic tasks within the number range up to 100. The results showed that children with CI achieved poorer results in phonemic fluency (z = -4.92; p < 0.001), semantic fluency (z = -3.89; p < 0.001), figural fluency (z = -3.07; p = 0.002), and arithmetic fluency (z = -4.27; p < 0.001). In both groups, a positive correlation was obtained between the measured modalities and types of fluency. In the group of children with CI, a sex difference was obtained on the phonemic fluency test, in favor of girls. The age of children with CI was correlated with arithmetic fluency. Verbal, figural and arithmetic fluency of children with CI speak in favor of the importance of early auditory and language experiences.

Cochlear implant-specific risks should be considered, when assessing the quality of life of children and adolescents with hearing loss and cochlear implants-not just cochlear implant-specific benefits-Perspective

Cochlear implants (CIs) are electronic medical devices that enable hearing in cases where traditional hearing aids are of minimal or no use. Quality of life (QoL) studies of children and adolescents with a CI have so far focused on the CI-specific benefits. However, the CI-specific risks listed by the U.S. Food and Drug Administration have not yet been considered. From this list, medical and device-related complications, lifelong dependency on the implanted device, and neurosecurity risks (CI technology is an interface technology) may be particularly relevant for young CI users. Medical and device-related complications can cause physical discomfort (e.g., fever, pain), as well as functioning problems (e.g., in speech discrimination, social behavior, and mood). In the worst case, reimplantation is required. Clinical experience shows that these complications are perceived as a burden for young CI users. Furthermore, many young patients are worried about possible complications. Additionally, CIs can be at least a temporary burden when children, typically at the age of 8-9 years, realize that they need the CI for life, or when they become peer victims because of their CI. Concerning neurosecurity risks, it is still unknown how young CI recipients perceive them. In summary, CI-specific risks can be perceived as a burden by young CI users that impairs their QoL. Therefore, they should not be ignored. There is an urgent need for studies on this topic, which would not only be important for professionals and parents, but also for the design of CI-specific QoL instruments.

Numerical Magnitude Processing in Deaf Adolescents and Its Contribution to Arithmetical Ability

Although most deaf individuals could use sign language or sign/spoken language mix, hearing loss would still affect their language acquisition. Compensatory plasticity holds that the lack of auditory stimulation experienced by deaf individuals, such as congenital deafness, can be met by enhancements in visual cognition. And the studies of hearing individuals have showed that visual form perception is the cognitive mechanism that could explain the association between numerical magnitude processing and arithmetic computation. Therefore, we examined numerical magnitude processing and its contribution to arithmetical ability in deaf adolescents, and explored the differences between the congenital and acquired deafness. 112 deaf adolescents (58 congenital deafness) and 58 hearing adolescents performed a series of cognitive and mathematical tests, and it was found there was no significant differences between the congenital group and the hearing group, but congenital group outperformed acquired group in numerical magnitude processing (reaction time) and arithmetic computation. It was also found there was a close association between numerical magnitude processing and arithmetic computation in all deaf adolescents, and after controlling for the demographic variables (age, gender, onset of hearing loss) and general cognitive abilities (non-verbal IQ, processing speed, reading comprehension), numerical magnitude processing could predict arithmetic computation in all deaf adolescents but not in congenital group. The role of numerical magnitude processing (symbolic and non-symbolic) in deaf adolescents' mathematical performance should be paid attention in the training of arithmetical ability.

Tactile Enumeration and Embodied Numerosity Among the Deaf

Representations of the fingers are embodied in our cognition and influence performance in enumeration tasks. Among deaf signers, the fingers also serve as a tool for communication in sign language. Previous studies in normal hearing (NH) participants showed effects of embodiment (i.e., embodied numerosity) on tactile enumeration using the fingers of one hand. In this research, we examined the influence of extensive visuo-manual use on tactile enumeration among the deaf. We carried out four enumeration task experiments, using 1-5 stimuli, on a profoundly deaf group (n = 16) and a matching NH group (n = 15): (a) tactile enumeration using one hand, (b) tactile enumeration using two hands, (c) visual enumeration of finger signs, and (d) visual enumeration of dots. In the tactile tasks, we found salient embodied effects in the deaf group compared to the NH group. In the visual enumeration of finger signs task, we controlled the meanings of the stimuli presentation type (e.g., finger-counting habit, fingerspelled letters, both or neither). Interestingly, when comparing fingerspelled letters to neutrals (i.e., not letters or numerical finger-counting signs), an inhibition pattern was observed among the deaf. The findings uncover the influence of rich visuo-manual experiences and language on embodied representations. In addition, we propose that these influences can partially account for the lag in mathematical competencies in the deaf compared to NH peers. Lastly, we further discuss how our findings support a contemporary model for mental numerical representations and finger-counting habits.

Mental health problems in adolescents with cochlear implants: peer problems persist after controlling for additional handicaps

The aims of the present multi-center study were to investigate the extent of mental health problems in adolescents with a hearing loss and cochlear implants (CIs) in comparison to normal hearing (NH) peers and to investigate possible relations between the extent of mental health problems of young CI users and hearing variables, such as age at implantation, or functional gain of CI. The survey included 140 adolescents with CI (mean age = 14.7, SD = 1.5 years) and 140 NH adolescents (mean age = 14.8, SD = 1.4 years), their parents and teachers. Participants were matched by age, gender and social background. Within the CI group, 35 adolescents were identified as “risk cases” due to possible and manifest additional handicaps, and 11 adolescents were non-classifiable. Mental health problems were assessed with the Strengths and Difficulties Questionnaire (SDQ) in the versions “Self,” “Parent,” and “Teacher.” The CI group showed significantly more “Peer Problems” than the NH group. When the CI group was split into a “risk-group” (35 “risk cases” and 11 non-classifiable persons) and a “non-risk group” (n = 94), increased peer problems were perceived in both CI subgroups by adolescents themselves. However, no further differences between the CI non-risk group and the NH group were observed in any rater. The CI risk-group showed significantly more hyperactivity compared to the NH group and more hyperactivity and conduct problems compared to the CI non-risk group. Cluster analyses confirmed that there were significantly more adolescents with high problems in the CI risk-group compared to the CI non-risk group and the NH group. Adolescents with CI, who were able to understand speech in noise had significantly less difficulties compared to constricted CI users. Parents, teachers, and clinicians should be aware that CI users with additionally special needs may have mental health problems. However, peer problems were also experienced by CI adolescents without additional handicaps.