Communication dynamics between mothers and their children with cochlear implants: Effects of maternal support for language production

Linguistic Intervention Strategies Speech-Language Pathologists Use With Children Using Cochlear Implants

The aim of this study was to explore the strategies that speech-language pathologists (SLPs) use during their linguistic interventions on children with cochlear implants (CIs). The sample comprised 7 SLPs in interactions with 62 children, 31 with CIs and 31 with typical hearing (TH), from 5 to 7 years of age. Two linguistic activities were used: conversation and naming. With children with CIs, the SLPs used 3.8 times more adaptation strategies and 5 times more educational strategies in the conversation activity, and 1.4 times more educational strategies in the naming activity than with children with TH. Communication strategies were significantly more frequent in the conversation activity than in the naming activity while educational strategies were more frequent in the naming activity than in the conversation activity. The auditory age of children with CIs also influenced the use of these two types of strategies, increasing the use of communication strategies by 0.6% and decreasing the use of educational strategies by 1.2% for each month of increase in the auditory age. In order to foster linguistic development, the SLPs used a wide variety of strategies with the children with CIs, adjusting them to the activity and the auditory age.

Do Acoustic Environment Characteristics Affect the Lexical Development of Children With Cochlear Implants? A Longitudinal Study Before and After Cochlear Implant Activation

Purpose This study investigates the acoustic environment of children with cochlear implants (CIs) and the relationship between exposure to speech, in noise and in quiet, and the children's lexical production up to 1 year after CI activation, while controlling for the effect of early individual differences in receptive vocabulary growth. Method Eighteen children with CIs were observed at 3, 6, and 12 months after CI activation. Children's spontaneous word production during interaction with their mothers (types and tokens) and their expressive and receptive vocabulary size were considered. The characteristics of the acoustic environments in terms of acoustic scenes (speech in noise or in quiet, quiet, noise, music, and other) and of loudness ranges were assessed using data logging of the children's devices. Results Data analysis showed that both the number of tokens and the number of types produced 1 year after CI activation were affected by the children's exposure to speech in quiet with a loudness range between 40 and 69 dB. Expressive vocabulary size and types were affected by the receptive vocabulary knowledge that the children achieved over the first 3 months after CI activation. Conclusions Our data support the role of speech environment and individual differences in early comprehension on lexical production. The importance of exposure to speech with particular characteristics for the lexical development of children with CIs and the implications for clinical practice are discussed.

Mothers' emotional experiences related to their child's diagnosis of deafness and cochlear implant surgery: Parenting stress and child's language development

OBJECTIVES

The present study aims to assess the emotional experiences, specifically parenting stress, of mothers of children with cochlear implants (CIs), and their children's language development before surgery and at three and six months after CI activation.

METHODS

Twenty mothers of children with CIs were interviewed before their children's surgery about their experiences in connection with the diagnosis of deafness, the surgery and the activation of the CI. The Parenting Stress Index questionnaire and the MacArthur-Bates-Communication Development Inventory were administered before the surgery and at 3 and 6 months after the CI activation.

RESULTS

Analysis of the qualitative data resulting from the interviews showed that the mothers' emotional experiences before the CI surgery were complex. Mothers reported both positive and negative emotions related to deafness, diagnosis and surgery, benefits of the CI, coping strategies and future expectations. The mothers of children with more advanced lexical production six months after CI activation displayed a high frequency of themes related to positive emotions, thoughts and coping strategies before the surgery. Distress on the part of the mothers, perceptions of difficulties in their child and instances of parent-child dysfunctional interaction were negatively and significantly related to the child's language and communication development.

CONCLUSIONS

The findings support the importance of assessing the mother's emotional experience in relation to diagnosis and CI activation before the surgery. IMPLICATIONS FOR CLINICAL PRACTICE ARE DISCUSSED: specifically, the importance of the support offered to the parents, aimed at enhancing both their awareness of their expectations about their child's rehabilitation process and their self-efficacy in supporting the child's adaptation to the use of the CI.