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Peltokorpi S, Salo S, Nafstad A, Hart P, Biringen Z, Laakso M. Bodily-tactile early intervention: a pilot study of the role of maternal touch and emotional availability in interactions between three children with visual impairment and additional disabilities and their mothers. Front Psychol 2024; 15:1439605. [PMID: 39149707 PMCID: PMC11325483 DOI: 10.3389/fpsyg.2024.1439605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 07/04/2024] [Indexed: 08/17/2024] Open
Abstract
Background Children with visual impairment and additional disabilities (VIAD) have difficulty accessing the visual information related to their parents' facial expressions and gestures. Similarly, it may be hard for parents to detect their children's subtle expressions. These challenges in accessibility may compromise emotional availability (EA) in parent-child interactions. The systematic use of the bodily-tactile modality for expressive and receptive communicative functions may function as a strategy to compensate for a child's lack of vision. This multiple-case study explored the effects of a bodily-tactile early intervention for three mothers and their one-year-old children with VIAD. Methods Video data from baseline, intervention, and follow-up sessions were analyzed using a bodily-tactile coding procedure and EA Scales. Results During the intervention, all mothers began to use a more bodily-tactile modality in early play routines and in different communicative functions. They increased their use of anticipatory cues, noticing responses, and tactile signs. Moreover, the children were more emotionally available to their mothers during the intervention and follow-up compared to the baseline. Conclusion The results indicated that, during a short intervention, mothers could adopt a systematic use of the bodily-tactile modality in interactions with their children with VIAD. The results also suggest that, when mothers increased flexibility in communication channels, it was positively linked to their children's EA.
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Affiliation(s)
- Sini Peltokorpi
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
- Pediatric Research Center, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Saara Salo
- Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland
| | - Anne Nafstad
- Department of Combined Sensory Loss and Deafblindness, STATPED, Oslo, Norway
| | - Paul Hart
- Sense Scotland, Glasgow, United Kingdom
| | - Zeynep Biringen
- Department of Human Development & Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Minna Laakso
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
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Rebesco R, Colombani A, Handjaras G, Bottari D, Orzan E. Early assessment of communicative competence in children with hearing loss using the Child-Caregiver Communication Assessment through Rebesco's Evaluation (CC-CARE) method. Int J Pediatr Otorhinolaryngol 2024; 181:111927. [PMID: 38723425 DOI: 10.1016/j.ijporl.2024.111927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 06/15/2024]
Abstract
PURPOSE This work presents a new frame-by-frame video analysis method called Child-Caregiver Communication Assessment through Rebesco's Evaluation (CC-CARE), developed in the context of pediatric hearing loss as a rehabilitation tool for assessing children's early communication skills. CC-CARE stems from the commonly used Tait video analysis and extends it by including a new set of parameters aimed at disentangling between hearing-dependent and hearing-independent aspects of communication. METHOD In this paper, we collected video samples of child-caregiver interactions in a group of 65 normal-hearing children and a group of 165 hearing-impaired children. For each group, we present the CC-CARE method and describe the parameters, their score distributions, correlations and we estimate the adherence of the CC-CARE scores with children's developmental trajectory. Moreover, we compare the results of CC-CARE scores between the two groups having had different development of the auditory system. Finally, a fully-data driven approach was employed to assess the consistency of the communicative efficacy index (CEI), a score aiming to capture a global result of the CC-CARE procedure. RESULTS Correlations among parameter scores were found in each within-group analysis, revealing CC-CARE's internal consistency in measuring associated but nonoverlapping communication dimensions. For both groups, CC-CARE scores were associated with participants' age. Differences between scores emerged for a between-group analysis, indicating CC-CARE sensitivity to extract communication differences as a function of the hearing status. For both groups, the data analysis revealed that the CEI captures large variance portions across all parameter scores of the CC-CARE method. CONCLUSIONS Results provide the first evidence that the CC-CARE video analysis method could be a reliable tool capable of highlighting the cascading effects of hearing impairment on children's preverbal communicative efficacy. The CC-CARE method aims to support early rehabilitation of hearing loss by describing a child's communicative efficacy.
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Affiliation(s)
- Roberta Rebesco
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.
| | - Arianna Colombani
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy; International Doctorate for Experimental Approaches to Language and Brain (IDEALAB), University of Potsdam, Germany.
| | | | | | - Eva Orzan
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.
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Curtin M, Cruice M, Morgan G, Herman R. Assessing parent-child interaction with deaf and hard of hearing infants aged 0-3 years: An international multi-professional e-Delphi. PLoS One 2024; 19:e0301722. [PMID: 38683866 PMCID: PMC11057743 DOI: 10.1371/journal.pone.0301722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/21/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION Most deaf babies are born to hearing families who do not yet have the skills to communicate effectively with their child. Adaptations to communication are important because the quality of parent-child interaction (PCI) predicts how a deaf child develops language. Teachers of Deaf children and Speech and Language Therapists support families with communication in the home. Currently, there are no assessments that appraise how a parent interacts with their deaf baby. Previous research has identified which parent behaviours and approaches are used in PCI assessments in research and practice. The current paper forms consensus on the core content and best practices of a new PCI tool for deaf children aged 0-3 years. METHODS An international sample of expert academics and practitioners (n = 83) were recruited to take part in a two-round modified electronic Delphi study. Participants were presented with 69 statements focusing on (i) which parent behaviours were important in assessment (ii) the methods to be used in PCI assessment. Participants rated the extent to which they agreed or disagreed with each statement on a five-point Likert scale and gave comments to support their response. Consensus was defined as >80% of participants rating the statement as a (4) 'highly important' or a (5) 'essential'. If consensus was not reached, participant comments were used to generate new statements which were rated in the second round. This project involved a patient and public involvement (PPI) group of hearing and deaf parents and professionals to design and guide the study. RESULTS Consensus was achieved on 52 statements and ranged from 80-99%. A further six statements were additionally included. Within the 58 statements included, 36 were parent behaviours which centred on the parent's observation of, and response to, their child's behaviour and/or language. The remaining 22 statements focused on methods used in the assessment such as parents having their PCI filmed, parents having the opportunity to review the video and assess themselves alongside a professional, and parents being involved in subsequent goal setting. CONCLUSIONS This e-Delphi presented the parent behaviours and methods of assessment to be included in a new PCI tool for deaf children. Future co-production work and acceptability and feasibility testing are discussed.
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Affiliation(s)
- Martina Curtin
- Speech and Language Therapy (Paediatrics, Community), Homerton Healthcare NHS Foundation Trust, London, United Kingdom
- Language and Communication Science, City, University of London, London, United Kingdom
| | - Madeline Cruice
- Language and Communication Science, City, University of London, London, United Kingdom
| | - Gary Morgan
- Universitat Oberta de Catalunya, Psychology and Education Sciences, Barcelona, Spain
| | - Rosalind Herman
- Language and Communication Science, City, University of London, London, United Kingdom
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Saksida A, Rebesco R, Colombani A, Pintonello S, Tonon E, Santoro AM, Orzan E. The timeline of non-vocal and vocal communicative skills in infants with hearing loss. Front Pediatr 2024; 11:1209754. [PMID: 38283402 PMCID: PMC10811201 DOI: 10.3389/fped.2023.1209754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 12/26/2023] [Indexed: 01/30/2024] Open
Abstract
Objective The study investigates what is the link between early verbal and non-vocal abilities, when does predominantly verbal communicative style occur after the intervention with cochlear implants (CI) or hearing aids (HA), and how predictive it is of later linguistic development in deaf and hard of hearing (DHH) infants and children. Methods Cohort: children with moderate-to-profound hearing impairment (N = 49, 20 girls, mean age at HA or CI intervention = 15 months, range: 4-35 months). Measures Receptive and productive vocabulary at 24 and 36 months and video analysis at 12 months post-intervention. Analysis: Predictive values of total and verbal responses to communicative turns for later vocabulary development were assessed, as well as the relative time course of the development of vocal/verbal communication in DHH children. Results Vocabulary at 24 months is predicted by auditory responses at 12 months, as well as by overall responsiveness before intervention. Non-vocal responses decline and overall verbal responses increase significantly between 6 and 12 months after intervention. The trend is delayed in children with delayed (>12 months of age) treatment with CI or HA. Conclusions Age of intervention affects the development of vocal/verbal communicative style. Language development, in particular, vocabulary growth, can be further stimulated by the enhancement of preverbal (both vocal and non-vocal) communicative skills.
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Curtin M, Morgan G, Cruice M, Herman R. Assessing parent interaction with deaf infants: A quantitative survey of UK professional practice. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023. [PMID: 36708287 DOI: 10.1111/1460-6984.12849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 12/19/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Between 90% and 95% of deaf children are born to hearing parents who often need support with how to adapt their communication. Parent-child interaction (PCI) is an important predictor of deaf children's future language development. It is therefore necessary for professionals to assess parents' strengths and needs to identify areas for intervention. Qualified teachers of the deaf (QToDs), speech and language therapists (SLTs), psychologists, and national deaf child and adolescent mental health (NDCAMHS) professionals regularly support families with deaf children. With no current evidence-based tool available to assist with the assessment of PCI in deafness, it is important to gather information on current professional practice as this may differ from known practices within research. AIMS To survey the practices of UK-based professionals in the assessment of PCI where the deaf infant is aged 0-3 years. Professionals were QToDs, SLTs, psychologists or psychiatrists and professionals working at NDCAMHS services. METHODS & PROCEDURES After a pilot phase, an 85-item survey was distributed electronically through a range of professional and social media networks. Survey items were based on a systematic review of PCI with deaf infants. Survey questions were focused on parent behaviours that were assessed, methods of assessment, goal planning and service provision. Analysis was conducted using descriptive and inferential statistics. OUTCOMES & RESULTS A total of 190 professionals from across the UK completed part 1 of the survey; this decreased to 148 in part 4. Respondents were primarily female, hearing, used spoken English and had 16 years or more experience. Results indicate that PCI is routinely assessed by a large proportion of professionals and there is a substantial overlap in which parent behaviours are assessed. Some parent behaviours are assessed that do not feature in the research. Methods of assessment are informal and predominantly consist of observation and note making, with professionals using their own skills and experience to analyse interaction. Goal setting practices were largely similar between professionals, with many jointly deciding goals with parents. CONCLUSIONS & IMPLICATIONS This survey highlights the range of parent behaviours assessed by UK professionals in PCI with deaf children aged 0-3. This survey provides valuable information about and for professionals who assess PCI and set intervention goals with parents. Information from research and professional practice is important to consider in the design of a future PCI assessment. Implications are included for future research in this area. WHAT THIS PAPER ADDS What is already known on this subject Parental involvement is one of the greatest predictors of deaf children's language outcomes. With many deaf children born to hearing parents, parents often need guidance with how to facilitate effective communication. A recent systematic review identified the range of parent behaviours and methods used to analyse PCI in international research studies, but little evidence or guidance exists on how professionals assess this phenomenon in practice. What this study adds This is the first survey to generate large, valuable practice-based evidence for the assessment of parents' communication behaviours as they interact with their deaf infants aged 0-3. The survey recruited a range of multidisciplinary professionals working on interaction within this field: SLTs, qualified teachers of the deaf, psychologists or psychiatrists, and professionals working within deaf child and adolescent mental health services. The study reports on which behaviours these professionals assess and how, and includes information on the goal setting behaviours of practitioners. Most respondents were highly experienced; the survey, therefore, reveals expert practice within the field. What are the potential or actual clinical implications of this work? We recommend the following practice: (1) incorporate a range of parent-based behaviours in PCI assessments, including establishing joint engagement and parental sensitivity, as well as communication-focused behaviours; (2) video record PCI assessments where possible to enable professionals and parents to watch and reflect together; (3) following assessment, set parent-focused goals in collaboration with families, ensuring parents' skills, particularly their strengths, are considered. All primary caregivers should be included in the process where possible; and (4) reassess PCI regularly (at least termly) to monitor and encourage families' progress. The timing of reviews should be discussed between parent and professional.
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Affiliation(s)
- Martina Curtin
- Speech and Language Therapy (Paediatrics, Community), Homerton University Hospital NHS Foundation Trust, London, UK
- Language and Communication Science, City, University of London, London, UK
| | - Gary Morgan
- Language and Communication Science, City, University of London, London, UK
| | - Madeline Cruice
- Language and Communication Science, City, University of London, London, UK
| | - Rosalind Herman
- Language and Communication Science, City, University of London, London, UK
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Mundayoor SA, Bhatarai P, Prabhu P. A comparison of the quality of life of parents of children using hearing aids and those using cochlear implants. J Otol 2022; 17:211-217. [PMID: 36249924 PMCID: PMC9547105 DOI: 10.1016/j.joto.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/29/2022] [Accepted: 06/22/2022] [Indexed: 12/02/2022] Open
Abstract
Objective The goal of this study was to evaluate the quality of life of parents of children who use hearing aids (HA) with those who use cochlear implants (CI) in the Indian context and document any differences found. Methods The Kannada version of the AQoL-4D was administered in a modified fashion to 131 parents (87 HA and 44 CI). Sociodemographic details were collected for supplemental information on the intervention strategy used. Results A total of 49 parents (29 HA and 20 CI) responded to the questionnaire sent. The mean total scores for both the groups were similar (HA group = 17.9 (SD = 5.5), CI group = 17.2 (SD = 3.4)), as was the score for the first subscale (HA group = 8.6 (SD = 2.9); CI group = 8.5 (SD = 2.6)) of the AQoL-4D. No significant differences were found between the two groups on either scores [Total Score: U (NHA = 29, NCI = 20) = 280.5, z = -0.194, p > 0.05; Subscale 1 Score: U (NHA = 29, NCI = 20) = 281.5, z = -0.176, p > 0.05]. The degree of hearing loss in the hearing aid group was equivalent to that of the cochlear implant group but this did not appear to influence parental quality of life. Conclusion Parents of children with hearing aids and cochlear implants appear to be similar on several psychosocial factors in the realms of functional, social, and psychological well-being. In terms of parental quality of life, hearing aids and cochlear implants appear to be equally effective intervention techniques.
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Blank A, Holt RF. Associations Between Paternal Play and Executive Function in Deaf and Hard of Hearing Children. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3056-3078. [PMID: 35868293 PMCID: PMC9911117 DOI: 10.1044/2022_jslhr-21-00661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/10/2022] [Accepted: 04/19/2022] [Indexed: 05/22/2023]
Abstract
PURPOSE Responsive and dynamic aspects of father-child play are associated with behavioral and neurocognitive development in children and could represent an important contributor to executive function (EF) skills for children who are deaf and hard of hearing (DHH). This study examined associations between paternal behaviors during play and EF skills of DHH children and children with typical hearing (TH). METHOD Father-child dyads in families with DHH children (n = 30) and TH children (n = 29) participated in a 15-min video-recorded free-play session that was coded for parental behaviors using Parent-Child Interaction Rating Scales and Rough and Tumble Play Quality. Families also completed an age-appropriate version of the Behavior Rating Index of Executive Function as a measure of child EF. RESULTS DHH children were rated as having significantly more everyday difficulties with working memory than TH children. Fathers of DHH children were rated as more intrusive during play than fathers of TH children; however, there were no other differences between paternal groups on coded dimensions of father child play. Paternal respect for child autonomy was associated with fewer child difficulties with planning and organization skills and paternal play engagement was associated with fewer child EF difficulties. Moderation analyses revealed that paternal sensitivity was associated with more working memory difficulties and paternal respect for child autonomy was associated with fewer working memory difficulties for DHH children only. CONCLUSIONS Paternal play could be an important environmental context for DHH outcomes. Fathers supporting independent play might generally support EF. Paternal engagement in play might also benefit EF. Results highlight paternal behavioral attributes that could lead to potential father-embedded intervention models.
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Affiliation(s)
- Andrew Blank
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Rachael Frush Holt
- Department of Speech and Hearing Science, The Ohio State University, Columbus
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Holzinger D, Hofer J, Dall M, Fellinger J. Multidimensional Family-Centred Early Intervention in Children with Hearing Loss: A Conceptual Model. J Clin Med 2022; 11:jcm11061548. [PMID: 35329873 PMCID: PMC8949393 DOI: 10.3390/jcm11061548] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 02/04/2023] Open
Abstract
At least two per thousand newborns are affected by hearing loss, with up to 40% with an additional disability. Early identification by universal newborn hearing screening and early intervention services are available in many countries around the world, with limited data on their effectiveness and a lack of knowledge about specific intervention-related determinants of child and family outcomes. This concept paper aimed to better understand the mechanisms by which multi-dimensional family-centred early intervention influences child outcomes, through parent behaviour, targeted by intervention by a review of the literature, primarily in the field of childhood hearing loss, supplemented by research findings on physiological and atypical child development. We present a conceptual model of influences of multi-disciplinary family-centred early intervention on family coping/functioning and parent–child interaction, with effects on child psycho-social and cognitive outcomes. Social communication and language skills are postulated as mediators between parent–child interaction and non-verbal child outcomes. Multi-disciplinary networks of professionals trained in family-centred practice and the evaluation of existing services, with respect to best practice guidelines for family-centred early intervention, are recommended. There is a need for longitudinal epidemiological studies, including specific intervention measures, family behaviours and multidimensional child outcomes.
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Affiliation(s)
- Daniel Holzinger
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4020 Linz, Austria; (J.H.); (M.D.); (J.F.)
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Institute of Linguistics, University of Graz, 8010 Graz, Austria
- Correspondence: or
| | - Johannes Hofer
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4020 Linz, Austria; (J.H.); (M.D.); (J.F.)
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Department of Paediatrics I, Innsbruck Medical University, 6020 Innsbruck, Austria
| | - Magdalena Dall
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4020 Linz, Austria; (J.H.); (M.D.); (J.F.)
| | - Johannes Fellinger
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, 4020 Linz, Austria; (J.H.); (M.D.); (J.F.)
- Institute of Neurology of Senses and Language, Hospital of St. John of God, 4020 Linz, Austria
- Division of Social Psychiatry, University Clinic for Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria
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Jamsek IA, Holt RF, Kronenberger WG, Pisoni DB. Differential At-Risk Pediatric Outcomes of Parental Sensitivity Based on Hearing Status. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:3668-3684. [PMID: 34463547 PMCID: PMC8642085 DOI: 10.1044/2021_jslhr-20-00491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Purpose The aim of this study was to investigate the role of parental sensitivity in language and neurocognitive outcomes in children who are deaf and/or hard of hearing (DHH). Method Sixty-two parent-child dyads of children with normal hearing (NH) and 64 of children who are DHH (3-8 years) completed parent and child measures of inhibitory control/executive functioning and child measures of sentence comprehension and vocabulary. The dyads also participated in a video-recorded, free-play interaction that was coded for parental sensitivity. Results There was no evidence of associations between parental sensitivity and inhibitory control or receptive language in children with NH. In contrast, parental sensitivity was related to children's inhibitory control and all language measures in children who are DHH. Moreover, inhibitory control significantly mediated the association between parental sensitivity and child language on the Clinical Evaluation of Language Fundamentals-Fifth Edition Following Directions subscale (6-8 years)/Clinical Evaluation of Language Fundamentals Preschool-Second Edition Concepts and Following Directions subscale (3-5 years). Follow-up analyses comparing subgroups of children who used hearing aids (n = 29) or cochlear implants (CIs; n = 35) revealed similar correlational trends, with the exception that parental sensitivity showed little relation to inhibitory control in the group of CI users. Conclusions Parental sensitivity is associated with at-risk language outcomes and disturbances in inhibitory control in young children who are DHH. Compared to children with NH, children who are DHH may be more sensitive to parental behaviors and their effects on emerging inhibitory control and spoken language. Specifically, inhibitory control, when scaffolded by positive parental behaviors, may be critically important for robust language development in children who are DHH.
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Affiliation(s)
- Izabela A. Jamsek
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Rachael Frush Holt
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - William G. Kronenberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis
- DeVault Otologic Research Laboratory, Department of Otolaryngology–Head and Neck Surgery, Indiana University School of Medicine, Indianapolis
| | - David B. Pisoni
- DeVault Otologic Research Laboratory, Department of Otolaryngology–Head and Neck Surgery, Indiana University School of Medicine, Indianapolis
- Department of Psychological and Brain Sciences, Indiana University Bloomington
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Majorano M, Brondino M, Guerzoni L, Murri A, Ferrari R, Lavelli M, Cuda D, Yoshinaga-Itano C, Morelli M, Persici V. Do Acoustic Environment Characteristics Affect the Lexical Development of Children With Cochlear Implants? A Longitudinal Study Before and After Cochlear Implant Activation. Am J Audiol 2021; 30:602-615. [PMID: 34139130 DOI: 10.1044/2021_aja-20-00104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
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.
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Affiliation(s)
| | | | - Letizia Guerzoni
- Otorhinolaryngology Unit, “Guglielmo da Saliceto” Hospital, Piacenza, Italy
| | - Alessandra Murri
- Otorhinolaryngology Unit, “Guglielmo da Saliceto” Hospital, Piacenza, Italy
| | | | | | - Domenico Cuda
- Otorhinolaryngology Unit, “Guglielmo da Saliceto” Hospital, Piacenza, Italy
| | | | - Marika Morelli
- Department of Human Sciences, University of Verona, Italy
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MacMillan KK, Lewis AJ, Watson SJ, Bourke D, Galbally M. Maternal social support, depression and emotional availability in early mother-infant interaction: Findings from a pregnancy cohort. J Affect Disord 2021; 292:757-765. [PMID: 34167025 DOI: 10.1016/j.jad.2021.05.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 05/11/2021] [Accepted: 05/23/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Social support theory suggests that parental social support may influence the nature of early parenting behaviours and specifically the mother-infant relationship. This study examines whether support from a partner, friends or family is associated with differences in quality of mother-infant interactions in the context of maternal depression. METHODS 210 women were followed from early pregnancy to six months postpartum within Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS). Mother-infant interactions within a standardised observation at six months postpartum were measured by the Emotional Availability (EA) Scales using total scores of the parental scales. In early and late pregnancy and at six months postpartum, mothers rated perceived maternal social support from a partner, family and friends using subscales of the Multidimensional Scale of Perceived Social Support. Depression was measured in early pregnancy and at six months postpartum using the Structured Clinical Interview for the DSM-IV-TR, with repeated measurement of depressive symptoms by the Edinburgh Postnatal Depression Scale (EPDS). Data was analysed using structural equation models. RESULTS There were significant interactions between depressive symptoms in early pregnancy and perceived maternal support from a partner (B = .18, 95% CI = 03, .31) and separately from family (B = .12, 95% CI = .03, .32) in predicting maternal emotional availability. No such interaction was found for support from friends. While partner and family support moderated the association between early depressive symptoms and emotional availability, there were no direct associations between maternal depressive disorder in early pregnancy and perceived support, and further, maternal depression was not a significant predictor of emotional availability. LIMITATIONS Future studies should consider extending measurement of the mother-infant relationship beyond the EA Scales, inclusion of a measure of maternal childhood trauma, and replicating our findings. CONCLUSION Maternal perception of partner and family support in the postpartum is a predictor of the association between early pregnancy depressive symptoms and maternal emotional availability.
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Affiliation(s)
- Kelli K MacMillan
- School of Medicine, University of Notre Dame, Fremantle, Australia; Psychology, Murdoch University, Perth, Australia; Women's Health, Genetics and Mental Health Directorate, King Edward Memorial Hospital for Women, Subiaco, Australia
| | | | - Stuart J Watson
- School of Medicine, University of Notre Dame, Fremantle, Australia; Psychology, Murdoch University, Perth, Australia
| | | | - Megan Galbally
- School of Medicine, University of Notre Dame, Fremantle, Australia; Psychology, Murdoch University, Perth, Australia; Women's Health, Genetics and Mental Health Directorate, King Edward Memorial Hospital for Women, Subiaco, Australia; Faculty of Health and Medicine Sciences, University of Western Australia, Perth, Australia.
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Assessing Parent Behaviours in Parent-Child Interactions with Deaf and Hard of Hearing Infants Aged 0-3 Years: A Systematic Review. J Clin Med 2021; 10:jcm10153345. [PMID: 34362128 PMCID: PMC8348634 DOI: 10.3390/jcm10153345] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Despite early identification and advancements in cochlear implant and hearing aid technology, delays in language skills in deaf children continue to exist. Good-quality parent–child interaction (PCI) is a key predictor for the successful development of deaf children’s signed and/or spoken language. Though professionals have standard assessments to monitor child language, a clinical tool to observe the quality of parental interaction is yet to be developed. Aims and methods: This systematic review with narrative synthesis aims to uncover which parent behaviours are assessed in PCI studies with deaf infants aged 0–3 years, how these behaviours are assessed, and which are correlated with higher scores in child language. Results: Sixty-one papers were included, spanning 40 years of research. Research included in the review assessed parents’ skills in gaining attention, joint engagement, emotional sensitivity, and language input. PCI was mostly assessed using coding systems and frame-by-frame video analysis. Some of the parent behaviours mentioned previously are associated with more words produced by deaf children. Conclusion: The results of the review provide the evidence base required to develop the content of a future clinical assessment tool for parent–child interaction in deafness.
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Holt RF, Beer J, Kronenberger WG, Pisoni DB, Lalonde K, Mulinaro L. Family Environment in Children With Hearing Aids and Cochlear Implants: Associations With Spoken Language, Psychosocial Functioning, and Cognitive Development. Ear Hear 2021; 41:762-774. [PMID: 31688320 PMCID: PMC7190421 DOI: 10.1097/aud.0000000000000811] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To examine differences in family environment and associations between family environment and key speech, language, and cognitive outcomes in samples of children with normal hearing and deaf and hard-of-hearing (DHH) children who use hearing aids and cochlear implants. DESIGN Thirty families of children with normal hearing (n = 10), hearing aids (n = 10), or cochlear implants (n = 10) completed questionnaires evaluating executive function, social skills, and problem behaviors. Children's language and receptive vocabulary were evaluated using standardized measures in the children's homes. In addition, families were administered a standardized in-home questionnaire and observational assessment regarding the home environment. RESULTS Family environment overall was similar across hearing level and sensory aid, although some differences were found on parental responsivity and physical environment. The level of supportiveness and enrichment within family relationships accounted for much of the relations between family environment and the psychosocial and neurocognitive development of DHH children. In contrast, the availability of objects and experiences to stimulate learning in the home was related to the development of spoken language. CONCLUSIONS Whereas broad characteristics of the family environments of DHH children may not differ from those of hearing children, variability in family functioning is related to DHH children's at-risk speech, language, and cognitive outcomes. Results support the importance of further research to clarify and explain these relations, which might suggest novel methods and targets of family-based interventions to improve developmental outcomes.
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Affiliation(s)
- Rachael Frush Holt
- Department of Speech and Hearing Sciences, Ohio State University, Columbus, OH, USA
| | - Jessica Beer
- DeVault Otologic Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
- The Urban Chalkboard, Indianapolis, IN
| | - William G. Kronenberger
- DeVault Otologic Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - David B. Pisoni
- DeVault Otologic Research Laboratory, Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Kaylah Lalonde
- Department of Speech and Hearing Sciences, Indiana University, Bloomington, IN, USA
| | - Lindsay Mulinaro
- Department of Speech and Hearing Sciences, Indiana University, Bloomington, IN, USA
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Curtin M, Herman R, Cruice M, Morgan G. Assessing parent-child interaction in infant deafness. Curr Opin Otolaryngol Head Neck Surg 2021; 29:200-203. [PMID: 33797421 PMCID: PMC7610700 DOI: 10.1097/moo.0000000000000710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW To highlight the importance of parent-child interaction (PCI) in infant deafness and address the lack of robust assessment tools in clinical practice. RECENT FINDINGS Most deaf babies are born to hearing parents with little experience in deafness. Deafness can reduce access to spoken language. Despite advancements in amplification technology, deaf children still present with delays in attention and communication skills at the start of nursery. Research reports that hearing parents of deaf infants can be more directive during interaction, spend less time following the child's focus of attention, and have more difficulty achieving successful turn-taking in conversation. Much research tells us that these factors impact on the quality and quantity of PCI. Good PCI, in all infants, but especially so in deafness, is a strong predictor of child language outcomes. Teachers of the Deaf and Speech and Language Therapists are the first professionals to support families in the home. For these professionals, having an objective way of assessing PCI would greatly assist and standardise their practice. However, to date, there are no deaf-specific assessments to observe and appraise a parent's communication behaviours when interacting with their deaf child. SUMMARY Intervention studies with families of deaf children have shown success in improving parental sensitivity and facilitative language techniques. An observational assessment in parent-deaf child interaction would ensure that communication interventions are appropriately targeted on the individual family's needs.
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Affiliation(s)
- Martina Curtin
- Homerton University Hospital NHS Foundation Trust, London
- City, University of London
| | - Ros Herman
- Homerton University Hospital NHS Foundation Trust, London
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Sola AM, Vukkadala N, Giridhar S, Stephans J, Allen IE, Chan DK. Validation of a Hearing-Related Quality-of-Life Questionnaire for Parents and Deaf or Hard-of-Hearing Infants and Toddlers. Otolaryngol Head Neck Surg 2020; 165:360-369. [PMID: 33317400 DOI: 10.1177/0194599820976175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To design and validate a hearing-related quality-of-life questionnaire targeted toward parents and deaf or hard-of-hearing infants and toddlers: the Hearing-Related Infant/Toddler and Parent Quality of Life (HIP-QL) questionnaire. STUDY DESIGN Cross-sectional questionnaire and prospective instrument validation. SETTING Academic pediatric otolaryngology clinic. METHODS A 67-question questionnaire developed from constructs of a grounded theory analysis was administered to parents of 31 deaf or hard-of-hearing children and 14 typically hearing children. Questionnaire construct validity, reliability, and discriminant validity were tested. RESULTS Based on exploratory factor analysis, a 32-item construct composed of developmentally appropriate questions was reduced to a 17-item construct with 4 domains addressing quality of life for both child (auditory/communication behavior, temperament) and parent (management, parent-directed factors). Internal consistency measures were appropriate (Cronbach's alpha = 0.65), and test-retest reliability was high (intraclass correlation coefficient = 0.73). Total HIP-QL scores correlated significantly with related total PedsQL scores (r = 0.57, P < .001). As predicted, parents of children who are deaf or hard of hearing reported significantly lower mean HIP-QL scores but not mean PedsQL scores. HIP-QL was more sensitive than PedsQL for predicting case versus control membership (86.7% vs 76.9%). Multivariable regression confirmed a negative relationship between severity of hearing loss and HIP-QL score after controlling for age, sex, income, and maternal education. CONCLUSIONS This context-specific questionnaire is the first validated quality-of-life instrument for parents and deaf or hard-of-hearing infants and toddlers. Previously, parental stress and functional disability questionnaires were used as proxies; therefore, this questionnaire has the potential to serve as an important tool for patient- and caregiver-centered outcomes research.
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Affiliation(s)
- Ana Marija Sola
- School of Medicine, University of California-San Francisco, San Francisco, California, USA
| | - Neelaysh Vukkadala
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA
| | - Sonya Giridhar
- Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, USA
| | - Jihyun Stephans
- Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, USA
| | - Isabel Elaine Allen
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, USA
| | - Dylan K Chan
- Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, California, USA
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Mood D, Szarkowski A, Brice PJ, Wiley S. Relational Factors in Pragmatic Skill Development: Deaf and Hard of Hearing Infants and Toddlers. Pediatrics 2020; 146:S246-S261. [PMID: 33139438 PMCID: PMC11215649 DOI: 10.1542/peds.2020-0242d] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 11/24/2022] Open
Abstract
In this article, we review relational factors in early childhood believed to contribute in unique ways to pragmatic skill development in deaf and hard of hearing (DHH) infants and toddlers. These factors include attending to infant interactions with caregivers and others, supporting development of theory of mind through play and use of mental state language (ie, describing one's own or others' thoughts, feelings, and beliefs), and providing accessible opportunities for social interaction. On the basis of a review of the literature and clinical experience, we offer prescriptive strategies for supporting DHH children's development in these areas. To improve outcomes for DHH children, medical care providers and allied health professionals have a responsibility to support the development of young DHH children's pragmatic abilities by understanding these variables, coaching caregivers regarding their importance, and facilitating referrals for support when necessary.
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Affiliation(s)
- Deborah Mood
- Section of Developmental Pediatrics, Department of Pediatrics, University of Colorado, Aurora, Colorado;
- Contributed equally as co-first authors
| | - Amy Szarkowski
- Children's Center for Communication/Beverly School for the Deaf, Beverly, Massachusetts
- Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Harvard University, Boston, Massachusetts
- Contributed equally as co-first authors
| | | | - Susan Wiley
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Cincinatti Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
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Majorano M, Guerzoni L, Cuda D, Morelli M. Mothers' emotional experiences related to their child's diagnosis of deafness and cochlear implant surgery: Parenting stress and child's language development. Int J Pediatr Otorhinolaryngol 2020; 130:109812. [PMID: 31841781 DOI: 10.1016/j.ijporl.2019.109812] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 12/03/2019] [Accepted: 12/04/2019] [Indexed: 10/25/2022]
Abstract
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.
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Affiliation(s)
| | | | | | - Marika Morelli
- Department of Human Sciences, University of Verona, Italy
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18
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Su PL, Roberts MY. Quantity and Quality of Parental Utterances and Responses to Children With Hearing Loss Prior to Cochlear Implant. JOURNAL OF EARLY INTERVENTION 2019; 41:366-387. [PMID: 33311963 PMCID: PMC7731922 DOI: 10.1177/1053815119867286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This study investigated the extent to which parental language input to children with hearing loss (HL) prior to cochlear implant (CI) differs from input to children with typical hearing (TH). A 20-min parent-child interaction sample was collected for 13 parent-child dyads in the HL group and 17 dyads in the TH group during free play. Ten minutes were transcribed and were coded for four variables: (a) overall utterances, (b) high-quality utterances, (c) utterances in response to child communicative acts (i.e., overall responses), and (d) high-quality utterances in response to child communicative acts (i.e., high-quality responses). Differences were detected for both quantity and quality of parental language input across the two groups. Early language skills correlated with three out of the four parental variables in both groups. Post hoc analyses suggested that the lower rate of high-quality responses in parents of children with HL could be attributed to lower intelligibility of child communication.
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19
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Roberts MY. Parent-Implemented Communication Treatment for Infants and Toddlers With Hearing Loss: A Randomized Pilot Trial. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:143-152. [PMID: 30535174 PMCID: PMC6437700 DOI: 10.1044/2018_jslhr-l-18-0079] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/01/2018] [Accepted: 07/09/2018] [Indexed: 05/19/2023]
Abstract
Purpose Despite advances in cochlear implant and hearing aid technology, many children with hearing loss continue to exhibit poorer language skills than their hearing peers. This randomized pilot trial tested the effects of a parent-implemented communication treatment targeting prelinguistic communication skills in infants and toddlers with hearing loss. Method Participants included 19 children between 6 and 24 months of age with moderate to profound, bilateral hearing loss. Children were randomly assigned to the parent-implemented communication treatment group or a "usual care" control group. Parents and children participated in 26, hour-long home sessions in which parents were taught to use communication support strategies. The primary outcome measures were the Communication and Symbolic Behavior Scales (Wetherby & Prizant, 2003), a measure of child prelinguistic skills, and parental use of communication support strategies during a naturalistic play session. Results Parents in the treatment group increased their use of communication support strategies by 17%. Children in the treatment group made statistically significant more gains in speech prelinguistic skills ( d = 1.09, p = .03) as compared with the control group. There were no statistically significant differences in social and symbolic prelinguistic skills; however, the effect sizes were large ( d = 0.78, p = .08; d = 0.91, p = .10). Conclusions This study provides modest preliminary support for the short-term effects of a parent-implemented communication treatment for children with hearing loss. Parents learned communication support strategies that subsequently impacted child prelinguistic skills. Although these results appear promising, the sample size is very small. Future research should include a larger clinical trial and child-level predictors of response to treatment.
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Affiliation(s)
- Megan Y. Roberts
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
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20
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Costa EA, Day L, Caverly C, Mellon N, Ouellette M, Wilson Ottley S. Parent–Child Interaction Therapy as a Behavior and Spoken Language Intervention for Young Children With Hearing Loss. Lang Speech Hear Serv Sch 2019; 50:34-52. [DOI: 10.1044/2018_lshss-18-0054] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
The importance of early intervention for fostering language in children with hearing loss has been well documented; those that facilitate parent engagement are particularly effective. Listening and spoken language outcomes among children with hearing loss continue to fall short compared to hearing peers, despite improvements in hearing technologies. The current study evaluated the effectiveness of parent–child interaction therapy (PCIT) as a behavioral intervention for children with hearing loss and its applicability as a language intervention.
Method
PCIT effectiveness was evaluated for children with hearing loss (PCIT treatment group:
N
= 18). For a subset of the treatment group (matched experimental group:
n
= 6), pretreatment and posttreatment language samples were compared to a matched control group (
n
= 6).
Results
Significant changes were observed in parent skills and child behavior from pretreatment to posttreatment for the PCIT treatment group. A subset of the treatment group (matched experimental group) with available matched controls (matched control group) demonstrated a significant increase in utterances and a trend toward significant increase in receptive vocabulary compared to the control group.
Conclusion
PCIT is a promising intervention for children with hearing loss that empowers parents to engage in optimal indirect language stimulation, improves parent–child interactions, improves child behavior, and promotes spoken language skills.
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Affiliation(s)
| | - Lori Day
- Department of Psychology, Gallaudet University, Washington, DC
| | | | - Nancy Mellon
- The River School/Chattering Children Clinic, Washington, DC
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Frick MA, Forslund T, Brocki KC. Does child verbal ability mediate the relationship between maternal sensitivity and later self-regulation? A longitudinal study from infancy to 4 years. Scand J Psychol 2019; 60:97-105. [PMID: 30625240 DOI: 10.1111/sjop.12512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 11/12/2018] [Indexed: 11/29/2022]
Abstract
There is a need to further examine the mechanisms by which maternal sensitivity influences the development of child self-regulation. This study investigated the role of maternal sensitivity when infants were 10 months old and child verbal ability at 18 months, in relation to various aspects of self-regulation at 48 months, in a sample of 95 typically developing children (46.3% girls). In particular, the study examined, from a Vygotskian perspective, whether child verbal ability, as measured by receptive and expressive language, mediated the relationship between maternal sensitivity and hot and cool aspects of self-regulation in the child. As hypothesized, maternal sensitivity predicted child verbal ability, as well as working memory, set shifting, and delay of gratification. Child receptive language predicted set shifting, inhibition, and delay of gratification. In addition, receptive language mediated the relationship between maternal sensitivity and inhibition only. Additive effects of maternal sensitivity and child receptive language in relation to set shifting were found, and a main effect of maternal sensitivity on child delay of gratification. The results add to the body of research suggesting that responsive parenting and child verbal ability are important for the development of self-regulation, and suggest that different mechanisms may be at work for different aspects of self-regulation.
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22
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Campbell J. Understanding the Emotional Needs of Children who are Blind. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2019. [DOI: 10.1177/0145482x0710100605] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Julie Campbell
- School of Education, University of Western Sydney, Locked bag 1797, Penrith South DC, NSW 1797, Australia
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Vukkadala N, Giridhar SBP, Okumura MJ, Chan DK. Seeking equilibrium: The experiences of parents of infants and toddlers who are deaf/hard-of-hearing. J Pediatr Rehabil Med 2019; 12:11-20. [PMID: 30883371 DOI: 10.3233/prm-170528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To identify key determinants of the quality of life of caregivers of infants and toddlers (< 3 years) who are deaf/hard-of-hearing (DHH). METHODS We conducted focus groups with providers for children who are DHH as well as interviews with hearing parents of infants and toddlers who are DHH. A multi-step qualitative analysis on interview data using grounded theory was performed, and an iterative analysis to investigate codes to characterize specific topics in caring for deaf infants and toddlers was conducted. RESULTS Four focus groups (n= 33) and six semi-structured interviews (n= 7) were conducted. The major theoretical code found was the "Search for Equilibrium" in parenting which arose from the three main categories of the caregiver role/experience: (1) being a parent - modifying parenting style as a result of their child's hearing loss, (2) being a mediator - modulating and filtering interactions between their child and their child's environment, and (3) being a navigator - managing the logistics of the medical and educational system. CONCLUSIONS For hearing parents, the diagnosis of hearing loss requires changes in multiple domains of parenting. Support in each of these areas is critical for parents to restore a sense of equilibrium that is central to their quality of life. This framework provides a way to categorize parent experiences and may act as a template for focused interventions in the three identified domains.
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Affiliation(s)
- Neelaysh Vukkadala
- School of Medicine, University of California, San Francisco, CA, USA.,Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA, USA
| | - Sonya B P Giridhar
- Division of Pediatric Otolaryngology, University of California, San Francisco, CA, USA
| | - Megumi J Okumura
- Divisions of General Pediatrics and Internal Medicine, University of California, San Francisco, CA, USA
| | - Dylan K Chan
- Division of Pediatric Otolaryngology, University of California, San Francisco, CA, USA
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Are You There for Me? Joint Engagement and Emotional Availability in Parent–Child Interactions for Toddlers With Moderate Hearing Loss. Ear Hear 2019; 40:18-26. [DOI: 10.1097/aud.0000000000000596] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dirks E, Wauters L. It Takes Two to Read: Interactive Reading with Young Deaf and Hard-of-Hearing Children. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2018; 23:261-270. [PMID: 29635307 DOI: 10.1093/deafed/eny005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 02/21/2018] [Indexed: 06/08/2023]
Abstract
Interactive storybook reading is an important activity to enhance the emergent literacy skills of young deaf and hard-of-hearing (DHH) children. Parents have a crucial role to play in promoting their children's literacy development. However, parents often do not read in an interactive way; therefore guidance is recommended in applying these interactive reading strategies. In the present study we examined how parent reading behavior was affected by implementing an interactive reading training program for parents of young DHH children. Parents of 18 DHH toddlers in the Netherlands participated in a series of group training sessions and their interactive reading behavior was compared to that of 10 parents who did not participate. The results showed that parents' interactive reading behavior tended to increase after they participated in the interactive reading program. After the program, they applied the interactive reading strategies more often than parents who had not participated in the program. The findings suggest that interactive reading programs should be incorporated into early intervention programs for DHH children.
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Affiliation(s)
- Evelien Dirks
- Dutch Foundation for the Deaf and Hard of Hearing Child
- Leiden University
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Lavelli M, Majorano M, Guerzoni L, Murri A, Barachetti C, Cuda D. Communication dynamics between mothers and their children with cochlear implants: Effects of maternal support for language production. JOURNAL OF COMMUNICATION DISORDERS 2018; 73:1-14. [PMID: 29544117 DOI: 10.1016/j.jcomdis.2018.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 02/16/2018] [Accepted: 03/04/2018] [Indexed: 06/08/2023]
Abstract
This study examined (a) the functions and modalities of maternal and child communication during interaction between mothers and children with cochlear implants (CIs), comparing them with mothers and normally hearing (NH) children, and (b) the effectiveness of maternal support strategies in eliciting adequate answers in children with CI. Twenty preschoolers with CIs (M = 40 months) and 40 NH children - 20 matched by chronological age (CANH, M = 40 months) and 20 matched by hearing age (HANH, M = 25 months) - were videotaped during shared book reading and toy play with their mothers. Child and maternal utterances were coded for communicative functions and modalities (vocal, gestural, bimodal), including gesture types; maternal repairs were examined for type of support provided, and child answers for adequacy. Mothers in the CI group and in the CANH group displayed higher proportions of Informative Repairs than mothers of HANH children. However, unlike the mothers of NH children, mothers of children with CIs used bimodal utterances significantly more than vocal utterances. Sequential analysis revealed that maternal Informative Repairs elicited the production of Adequate Answers in both children with CIs and CANH. Interestingly, in the CI group this association was found only when Informative Repairs were accompanied by gestures. These findings offer suggestions for intervention programs focused on parent-child conversation.
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Affiliation(s)
| | | | - Letizia Guerzoni
- "Guglielmo da Saliceto" Hospital, Via Taverna Giuseppe, 49, 29121 Piacenza (PC), Italy.
| | - Alessandra Murri
- "Guglielmo da Saliceto" Hospital, Via Taverna Giuseppe, 49, 29121 Piacenza (PC), Italy.
| | | | - Domenico Cuda
- "Guglielmo da Saliceto" Hospital, Via Taverna Giuseppe, 49, 29121 Piacenza (PC), Italy.
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Brown EA, De Young A, Kimble R, Kenardy J. Review of a Parent’s Influence on Pediatric Procedural Distress and Recovery. Clin Child Fam Psychol Rev 2018; 21:224-245. [DOI: 10.1007/s10567-017-0252-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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28
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Roberts MY, Hampton LH. Exploring Cascading Effects of Multimodal Communication Skills in Infants With Hearing Loss. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2018; 23:95-105. [PMID: 29040615 PMCID: PMC5881374 DOI: 10.1093/deafed/enx041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 09/07/2017] [Indexed: 05/08/2023]
Abstract
Infants and toddlers with hearing loss (HL) are at risk for developing communicative delays that can have a substantial lasting effect. Understanding child characteristics that may be targeted in early intervention is essential to maximizing communicative outcomes in children with HL. Among the most malleable predictors of communication skills include maternal responsivity, gestures, and vocalizations. The purpose of this study was to examine the relationship among maternal responsivity, prelinguistic communication skills and expressive vocabulary in children with HL. Based upon the results we propose a theoretical cascading model of communicative outcomes for children with HL such that gesture use may be associated with future vocalizations which may in turn be related to long-term spoken language outcomes. This exploratory model may be supported by the underlying transactional model of bidirectional language development that occurs through maternal sensitivity in the first two years of life. Additionally, parents of children with HL may be less likely to respond to a single mode of communication than to a combination of modes. This exploratory study provides a theoretical framework by which multimodal communication development in infants and toddlers with HL may be better understood, and suggests hypotheses for future research and implications for intervention practice.
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Affiliation(s)
- Megan Y Roberts
- Northwestern University
- Correspondence should be sent to Megan Y. Roberts, Department of Communication Sciences and Disorders, Northwestern University, Frances Searle Building, 3-346 2240 Campus Drive, Evanston, IL 60208 (e-mail: )
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Wang Y, Bergeson TR, Houston DM. Infant-Directed Speech Enhances Attention to Speech in Deaf Infants With Cochlear Implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:3321-3333. [PMID: 29114770 PMCID: PMC5945082 DOI: 10.1044/2017_jslhr-h-17-0149] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 06/02/2017] [Accepted: 06/10/2017] [Indexed: 05/08/2023]
Abstract
Purpose Both theoretical models of infant language acquisition and empirical studies posit important roles for attention to speech in early language development. However, deaf infants with cochlear implants (CIs) show reduced attention to speech as compared with their peers with normal hearing (NH; Horn, Davis, Pisoni, & Miyamoto, 2005; Houston, Pisoni, Kirk, Ying, & Miyamoto, 2003), which may affect their acquisition of spoken language. The main purpose of this study was to determine (a) whether infant-directed speech (IDS) enhances attention to speech in infants with CIs, as compared with adult-directed speech (ADS), and (b) whether the degree to which infants with CIs pay attention to IDS is associated with later language outcomes. Method We tested 46 infants-12 prelingually deaf infants who received CIs before 24 months of age and had 12 months of hearing experience (CI group), 22 hearing experience-matched infants with NH (NH-HEM group), and 12 chronological age-matched infants with NH (NH-CAM group)-on their listening preference in 3 randomized blocks: IDS versus silence, ADS versus silence, and IDS versus ADS. We administered the Preschool Language Scale-Fourth Edition (PLS-4; Zimmerman, Steiner, & Pond, 2002) approximately 18 months after implantation to assess receptive and expressive language skills of infants with CIs. Results In the IDS versus silence block, all 3 groups looked significantly longer to IDS than to silence. In the ADS versus silence block, both the NH-HEM and NH-CAM groups looked significantly longer to ADS relative to silence; however, the CI group did not show any preference. In the IDS versus ADS block, whereas both the CI and NH-HEM groups preferred IDS over ADS, the NH-CAM group looked equally long to IDS and ADS. IDS preference quotient among infants with CIs in the IDS versus ADS block was associated with PLS-4 Auditory Comprehension and PLS-4 Expressive Communication measures. Conclusions Two major findings emerge: (a) IDS enhances attention to speech in deaf infants with CIs; (b) the degree of IDS preference over ADS relates to language development in infants with CIs. These results support a focus on input in developing intervention strategies to mitigate the effects of hearing loss on language development in infants with hearing loss.
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Affiliation(s)
- Yuanyuan Wang
- Department of Otolaryngology–Head & Neck Surgery, The Ohio State University, Columbus
| | - Tonya R. Bergeson
- Communication Sciences and Disorders, Butler University, Indianapolis, IN
| | - Derek M. Houston
- Department of Otolaryngology–Head & Neck Surgery, The Ohio State University, Columbus
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Wauters L, Dirks E. Interactive Reading with Young Deaf and Hard-of-Hearing Children in eBooks Versus Print Books. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2017; 22:243-252. [PMID: 28158684 DOI: 10.1093/deafed/enw097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 12/09/2016] [Indexed: 06/06/2023]
Abstract
Interactive storybook reading is effective in enhancing deaf and hard-of-hearing (DHH) children's emergent literacy skills. The current digital era gives parents more opportunities to read books with their child. From an early age on, interaction between parent and child during literacy activities is very important for the development of emergent literacy skills. The purpose of the present study was to explore the opportunities of eBooks on a tablet for interactive reading with young DHH children. Parent and child interactive behavior in reading print books was compared to eBooks in 18 parents and their 1- to 3-year-old DHH child. All parents followed an interactive reading program after which their interactive reading behaviors were observed while reading print books and eBooks with their child. Results mainly showed similar interactive reading behaviors in parents and children when reading print books or eBooks, except for a lower occurrence of pointing to pictures/objects in the parent behavior when reading the eBooks. These results give parents and professionals even more opportunities for interactive storybook reading with DHH children, and thus more opportunities to enhance their language and literacy skills. Tablets can be easily taken with you making eBooks accessible for interactive reading wherever you are.
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Affiliation(s)
| | - Evelien Dirks
- Dutch Foundation for the Deaf and Hard of Hearing Child
- Leiden University
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Dirks E, Ketelaar L, van der Zee R, Netten AP, Frijns JHM, Rieffe C. Concern for Others: A Study on Empathy in Toddlers with Moderate Hearing Loss. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2017; 22:178-186. [PMID: 27927686 DOI: 10.1093/deafed/enw076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 11/09/2016] [Indexed: 06/06/2023]
Abstract
Empathy, the ability to feel the emotions of others and respond affectively to these emotions, is an important factor in the development of social competence. The purpose of this study was to examine empathy levels in toddlers with moderate hearing loss (MHL) compared to toddlers with no hearing loss (nHL), and to explore the relation between language ability and empathy. We focused on affective empathy and the precursors of cognitive empathy. A total of 23 toddlers with MHL and 21 toddlers with nHL participated in the study. Parent report (ITSEA) and observation measures were used to rate the toddlers' levels of empathy. The results showed that the levels of affective empathy in toddlers with MHL and with nHL were similar on both measures. Toddlers with MHL lagged behind their peers with nHL on some precursors of cognitive empathy (intention understanding and joint attention). Language ability was unrelated to empathy levels in both groups of toddlers. In conclusion, toddlers with MHL seem to be at risk for problems in their empathy development. Although they are aware of the emotions of others, the development of more complex skills needed for an adequate empathic response is delayed in comparison with their hearing peers.
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Affiliation(s)
- Evelien Dirks
- Dutch Foundation for the Deaf and Hard of Hearing Child
- Leiden University
| | - Lizet Ketelaar
- Dutch Foundation for the Deaf and Hard of Hearing Child
- Leiden University
| | | | | | - Johan H M Frijns
- Leiden University Medical Center
- Leiden Institute for Brain and Cognition
| | - Carolien Rieffe
- Dutch Foundation for the Deaf and Hard of Hearing Child
- Leiden University
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Hintermair M, Sarimski K, Lang M. Preliminary Evidence Assessing Social-Emotional Competences in Deaf and Hard of Hearing Infants and Toddlers Using a New Parent Questionnaire. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2017; 22:143-154. [PMID: 27881483 DOI: 10.1093/deafed/enw070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 10/21/2016] [Indexed: 06/06/2023]
Abstract
Social-emotional competences are an important developmental domain for deaf and hard of hearing (DHH) children and early diagnosis of problems is needed to ensure that DHH children receive appropriate support in this domain. In order to explore the usefulness of an instrument, which was recently developed for very young children, two studies in DHH infants and toddlers were conducted from Germany using the Social-Emotional Assessment/Evaluation Measure (Squires et al. (2013). Social-Emotional Assessment/Evaluation Measure (SEAM). Baltimore, ML: Brooks). Preliminary analysis of data obtained from a sample of 182 DHH children aged between 2 and 36 months (Study 1) suggests that it provides valid, reliable data and is suitable for use in practice. The data also corroborate well-known findings from other research in deaf education, in particular the role of parental responsivity for the development of social-emotional competences. Study 2 documents the consistency of evaluations of 44 DHH children by their mothers and by early intervention providers using the scales. Overall, the results suggest that this new evaluation instrument has potential applications in deaf educational practice but further research is needed to demonstrate its full value.
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Hintermair M, Sarimski K, Lang M. [Social-emotional competences in deaf and hard-of-hearing toddlers – results from an empirical study with two current parent questionnaires]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2016; 45:128-140. [PMID: 27599207 DOI: 10.1024/1422-4917/a000468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objective Hearing loss in the deaf and hard of hearing (DHH) is associated with an elevated risk of problems in socio-emotional development. Early assessment is necessary to start timely interventions. The present study tested two parent questionnaires that allow evaluation of the socio-emotional development of toddlers from a competence perspective. Method 128 parents with DHH toddlers aged 18 to 36 months were asked to evaluate the development of their children and their own educational competences using two preliminary German adaptations of internationally well-known social-emotional assessment measures. Results In addition to a series of results within the normal range, the data also reveal some specific problems in the socio-emotional development of children with hearing loss. DHH toddlers in particular show more problems developing empathic competences and maintaining relations with peers. DHH toddlers with additional handicaps have a higher risk of developing socio-emotional problems. Parental responsivity proves to be important regarding the development of socio-emotional competences in toddlers. Conclusions The presented data strongly confirm results available from deaf research regarding the development and promotion of DHH children. The two questionnaires used in this study provide the opportunity to evaluate socio-emotional competences in DHH toddlers and to start appropriate interventions very early.
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Affiliation(s)
| | - Klaus Sarimski
- 1 Institut für Sonderpädagogik, Pädagogische Hochschule Heidelberg
| | - Markus Lang
- 1 Institut für Sonderpädagogik, Pädagogische Hochschule Heidelberg
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GIUNTINI G, FORLI F, NICASTRO R, CIABOTTI A, BRUSCHINI L, BERRETTINI S. Early care in children with permanent hearing impairment. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2016; 36:51-9. [PMID: 27054391 PMCID: PMC4825066 DOI: 10.14639/0392-100x-1079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 11/30/2015] [Indexed: 11/23/2022]
Abstract
The implementation of regional protocols for newborn hearing screening and early audiologic diagnosis represent the first step of the entire diagnostic, rehabilitative and prosthetic programme for children with permanent hearing impairment. The maximum benefit of early diagnosis can indeed be obtained only by prompt rehabilitation aimed at fostering the child's communicative, linguistic and cognitive development. Within the framework of the CMM 2013 project of the Ministry of Health entitled "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children", the problems concerning the promotion of the global development of children with PHI through an early rehabilitation project based on shared knowledge and scientific evidence. In this project, our specific aim was to define the features and modes of access to a precise and specialised rehabilitation project for the small hearing-impaired child within three months from audiologic diagnosis. Three main recommendations relative to assessment and rehabilitation aspects of early care emerged from the study.
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Affiliation(s)
- G. GIUNTINI
- U.O. ORL Audiologia e Foniatria Universitaria, Università di Pisa
| | - F. FORLI
- U.O. ORL Audiologia e Foniatria Universitaria, Università di Pisa
| | - R. NICASTRO
- U.O. ORL Audiologia e Foniatria Universitaria, Università di Pisa
| | - A. CIABOTTI
- U.O. ORL Audiologia e Foniatria Universitaria, Università di Pisa
| | - L. BRUSCHINI
- U.O. ORL Audiologia e Foniatria Universitaria, Università di Pisa
| | - S. BERRETTINI
- U.O. ORL Audiologia e Foniatria Universitaria, Università di Pisa, Operative Unit of Otorhinolaryngology, Audiology and Phoniatrics, University of Pisa, Italy, Guest Professor at Division of Ear, Nose and Throat Diseases, Dept. of Clinical Science, Intervention and Technology, Karolinska Istituet, Stockholm, Sweden
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Abstract
The landscape of service provision for young children with hearing loss has shifted in recent years as a result of newborn hearing screening and the early provision of interventions, including hearing technologies. It is expected that early service provision will minimize or prevent linguistic delays that typically accompany untreated permanent childhood hearing loss. The post-newborn hearing screening era has seen a resurgence of interest in empirically examining the outcomes of children with hearing loss to determine if service innovations have resulted in expected improvements in children's functioning. The Outcomes of Children with Hearing Loss (OCHL) project was among these recent research efforts, and this introductory article provides background in the form of literature review and theoretical discussion to support the goals of the study. The Outcomes of Children with Hearing Loss project was designed to examine the language and auditory outcomes of infants and preschool-age children with permanent, bilateral, mild-to-severe hearing loss, and to identify factors that moderate the relationship between hearing loss and longitudinal outcomes. The authors propose that children who are hard of hearing experience limitations in access to linguistic input, which lead to a decrease in uptake of language exposure and an overall reduction in linguistic experience. The authors explore this hypothesis in relation to three primary factors that are proposed to influence children's access to linguistic input: aided audibility, duration and consistency of hearing aid use, and characteristics of caregiver input.
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Affiliation(s)
- Mary Pat Moeller
- Boys Town National Research Hospital, Center for Childhood Deafness
| | - J. Bruce Tomblin
- University of Iowa, Department of Communication Sciences and Disorders
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The Relationship between Mothers’ Attachment Levels, Types of Verbal Control, and Infants’ Language Development. ADONGHAKOEJI 2015. [DOI: 10.5723/kjcs.2015.36.4.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Lam-Cassettari C, Wadnerkar-Kamble MB, James DM. Enhancing Parent-Child Communication and Parental Self-Esteem With a Video-Feedback Intervention: Outcomes With Prelingual Deaf and Hard-of-Hearing Children. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2015; 20:266-74. [PMID: 25819293 PMCID: PMC4450156 DOI: 10.1093/deafed/env008] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 02/23/2015] [Indexed: 05/08/2023]
Abstract
Evidence on best practice for optimizing communication with prelingual deaf and hard-of-hearing (DHH) children is lacking. This study examined the effect of a family-focused psychosocial video intervention program on parent-child communication in the context of childhood hearing loss. Fourteen hearing parents with a prelingual DHH child (Mage = 2 years 8 months) completed three sessions of video interaction guidance intervention. Families were assessed in spontaneous free play interactions at pre and postintervention using the Emotional Availability (EA) Scales. The Rosenberg Self-esteem Scale was also used to assess parental report of self-esteem. Compared with nontreatment baselines, increases were shown in the EA subscales: parental sensitivity, parental structuring, parental nonhostility, child responsiveness, and child involvement, and in reported self-esteem at postintervention. Video-feedback enhances communication in families with prelingual DHH children and encourages more connected parent-child interaction. The results raise implications regarding the focus of early intervention strategies for prelingual DHH children.
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Emotional availability (EA): Theoretical background, empirical research using the EA Scales, and clinical applications. DEVELOPMENTAL REVIEW 2014. [DOI: 10.1016/j.dr.2014.01.002] [Citation(s) in RCA: 204] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Yoshinaga-Itano C. Principles and guidelines for early intervention after confirmation that a child is deaf or hard of hearing. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2014; 19:143-175. [PMID: 24131505 DOI: 10.1093/deafed/ent043] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This document is a supplement to the year 2007 position statement of the Joint Committee on Infant Hearing and provides comprehensive guidelines for establishing strong early intervention (EI) systems with appropriate expertise to meet the needs of children who are deaf or hard of hearing (D/HH). Optimal outcomes can only be achieved when there is high quality to the universal newborn hearing screening programs, the audiologic diagnostic process of confirmation that a child is D/HH and fitting of amplification, and the provision of appropriate, individualized, targeted, and high-quality EI services. There are 12 best practice guidelines for EI programs that include the provision of timely referral to EI services with providers who have knowledge and skills in early childhood deafness and hearing loss, infusion within the system of partnerships with parents as well as professionals who are D/HH, longitudinal developmental assessments for monitoring the child's development, data management systems that include developmental outcomes, a process to monitor the fidelity of the intervention, and appropriate services for children with additional disabilities, those from non-English speaking families, and those from special populations, including unilateral hearing loss and auditory neuropathy/dyssynchrony.
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Affiliation(s)
- Christine Yoshinaga-Itano
- Speech, Language & Hearing Sciences, University of Colorado, Campus Box 409, Boulder, CO 80309-0409.
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Löfkvist U, Almkvist O, Lyxell B, Tallberg IM. Lexical and semantic ability in groups of children with cochlear implants, language impairment and autism spectrum disorder. Int J Pediatr Otorhinolaryngol 2014; 78:253-63. [PMID: 24332667 DOI: 10.1016/j.ijporl.2013.11.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Revised: 11/11/2013] [Accepted: 11/17/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Lexical-semantic ability was investigated among children aged 6-9 years with cochlear implants (CI) and compared to clinical groups of children with language impairment (LI) and autism spectrum disorder (ASD) as well as to age-matched children with normal hearing (NH). In addition, the influence of age at implantation on lexical-semantic ability was investigated among children with CI. METHODS 97 children divided into four groups participated, CI (n=34), LI (n=12), ASD (n=12), and NH (n=39). A battery of tests, including picture naming, receptive vocabulary and knowledge of semantic features, was used for assessment. A semantic response analysis of the erroneous responses on the picture-naming test was also performed. RESULTS The group of children with CI exhibited a naming ability comparable to that of the age-matched children with NH, and they also possessed a relevant semantic knowledge of certain words that they were unable to name correctly. Children with CI had a significantly better understanding of words compared to the children with LI and ASD, but a worse understanding than those with NH. The significant differences between groups remained after controlling for age and non-verbal cognitive ability. CONCLUSIONS The children with CI demonstrated lexical-semantic abilities comparable to age-matched children with NH, while children with LI and ASD had a more atypical lexical-semantic profile and poorer sizes of expressive and receptive vocabularies. Dissimilar causes of neurodevelopmental processes seemingly affected lexical-semantic abilities in different ways in the clinical groups.
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Affiliation(s)
- Ulrika Löfkvist
- Department of Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden; Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, (CLINTEC), Karolinska Institutet, Stockholm, Sweden; HEAD Graduate School, Linnaeus HEAD, Linköping University, Linköping, Sweden.
| | - Ove Almkvist
- Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Björn Lyxell
- HEAD Graduate School, Linnaeus HEAD, Linköping University, Linköping, Sweden; The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden
| | - Ing-Mari Tallberg
- Department of Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden; Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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Vohr BR, Topol D, Watson V, St Pierre L, Tucker R. The importance of language in the home for school-age children with permanent hearing loss. Acta Paediatr 2014; 103:62-9. [PMID: 24117984 DOI: 10.1111/apa.12441] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 09/13/2013] [Accepted: 09/27/2013] [Indexed: 11/27/2022]
Abstract
AIM To determine the characteristics of the natural spoken language environment associated with better language skills at school age of children with permanent hearing loss (HL) screened in a newborn hearing screen programme. METHODS A language processor recorded language environment including child vocalisations (CVs), conversational turns (CTs), adult word count (AWC), percentage of language and percentage of silence in 23 children with HL and 41 hearing controls. Relationships of language environment scores with Reynell language scores were analysed. RESULTS Children with HL had significantly lower Reynell comprehension scores (15-25 points; p = 0.0001) and expressive scores (7-12 points; NS) than hearing children. In regression analyses for the children with HL, after adjusting for age of entry to early intervention and stay in a NICU, every increase in ten percentage points of language in the home was associated with 7.2 points higher comprehension score (p = 0.027) and 9.99 points higher expressive score (p = 0.006). After adjusting for nonverbal intelligence, similar independent effects of the language environment on both comprehension (p = 0.027) and expressive scores (p = 0.006) were identified. CONCLUSION A rich language environment in the home is associated with better language abilities, which are necessary for academic success for children with permanent HL at school age.
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Affiliation(s)
- Betty R Vohr
- Women and Infants Hospital; The Alpert Medical School of Brown University; Providence RI USA
| | - Deborah Topol
- Women and Infants Hospital; The Alpert Medical School of Brown University; Providence RI USA
| | - Victoria Watson
- Women and Infants Hospital; The Alpert Medical School of Brown University; Providence RI USA
| | - Lucille St Pierre
- Women and Infants Hospital; The Alpert Medical School of Brown University; Providence RI USA
| | - Richard Tucker
- Women and Infants Hospital; The Alpert Medical School of Brown University; Providence RI USA
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Sarant J, Garrard P. Parenting stress in parents of children with cochlear implants: relationships among parent stress, child language, and unilateral versus bilateral implants. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2014; 19:85-106. [PMID: 23813672 DOI: 10.1093/deafed/ent032] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Little attention has been focused on stress levels of parents of children with cochlear implants (CIs). This study examined the stress experience of 70 parents of children with CIs by comparing stress levels in this group of parents to those in parents of children without disabilities, identifying primary stressors, examining the relationship between parent stress and child language, and comparing stress in parents of children with bilateral and unilateral CIs. Parents completed a parent stress questionnaire, and the receptive vocabulary and language abilities of the children were evaluated. Results indicated that these parents had a higher incidence of stress than the normative population. Parent stress levels and child language outcomes were negatively correlated. Child behavior and lack of spousal and social support were the prime causes of parent stress. Parents of children with bilateral CIs were significantly less stressed than were parents of children with unilateral CIs.
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Affiliation(s)
- Julia Sarant
- Audiology & Speech Pathology, The University of Melbourne, 550 Swanston Street, Parkville, Victoria 3010, Australia.
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Reichmuth K, Embacher AJ, Matulat P, Am Zehnhoff-Dinnesen A, Glanemann R. Responsive parenting intervention after identification of hearing loss by Universal Newborn Hearing Screening: the concept of the Muenster Parental Programme. Int J Pediatr Otorhinolaryngol 2013; 77:2030-9. [PMID: 24182601 DOI: 10.1016/j.ijporl.2013.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 10/01/2013] [Accepted: 10/03/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Parents of newborns with hearing loss (HL) identified by Universal Newborn Hearing Screening (UNHS) programmes wish for educational support soon after confirmation and for contact with other affected families. Besides pedaudiological care, a high level of family involvement and an early start of educational intervention are the best predictors for successful oral language development in children with HL. The implementation of UNHS has made it necessary to adapt existing intervention concepts for families of children with HL to the needs of preverbal infants. In particular, responsiveness has proven to be a crucial skill of intuitive parental behaviour in early communication between parents and their child. Since infants with HL are being fitted earlier with hearing devices, their chances of learning oral language naturally in daily communication with family members have noticeably improved. OBJECTIVES The Muenster Parental Programme (MPP) aims at empowering parents in communicating with their preverbal child with HL and in (re-)building confidence in their own parental resources. Additionally, it supplies specific information about auditory and language development and enables exchange with other affected parents shortly after the diagnosis. CONCEPT The MPP is a responsive parenting intervention specific to the needs of parents of infants with HL identified by UNHS or through other indices and testing within the first 18 months of life. It is based on the communication-oriented Natural Auditory Oral Approach and trains parental responsiveness to preverbal (3-18 months) infants with HL. The MPP has been developed for groups of 4-6 families and comprises six group sessions (without infants), two single training sessions with video feedback, and two individual counselling sessions. At the age of 24-30 months, an individual refresher training session is offered to the parents for adapting their responsiveness to the current verbal level of the child via dialogic book reading. The programme also benefits parents of paediatric cochlear implant (CI) candidates preimplantation and postimplantation. CONCLUSIONS The MPP is evidence-based (see Glanemann et al., this volume) and meets the current need for effective family-centred educational intervention after UNHS.
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Affiliation(s)
- Karen Reichmuth
- Clinic for Phoniatrics and Pedaudiology, University Hospital Muenster, Germany.
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James DM, Wadnerkar-Kamble MB, Lam-Cassettari C. Video feedback intervention: a case series in the context of childhood hearing impairment. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2013; 48:666-678. [PMID: 24165363 DOI: 10.1111/1460-6984.12039] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Recent research shows that parental sensitivity can explain a significant and unique amount of growth in speech and language outcomes in children with cochlear implants. In this intervention study we explored the impact of an intervention designed to support parental sensitivity on children's communication development. AIMS This study tests the effect of a complex intervention in the context of childhood hearing impairment using a case study design of three families. Propositions for each case were made using parental report of the child's development in an attempt to identify change in outcome measurements that were not likely to be due to general development in the child or a halo effect from the intervention. METHODS AND RESULTS Multiple pre- and post-intervention measures were taken. Outcome measures were mother-child contingencies to vocal utterances, emotional availability and an assessment of early communication in the child. Results for each case showed that improvements in some outcome measurements were found after the intervention and were maintained at follow-up. CONCLUSIONS & IMPLICATIONS Taking account of developmental change in intervention studies with children is challenging. Single-subject intervention studies can be designed to allow research interventions to be tailored to meet families' specific needs. Video interaction guidance may support pre-linguistic communicative development in children with hearing impairment.
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Affiliation(s)
- Deborah M James
- Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK; NIHR Nottingham Biomedical Research Unit in Hearing, University of Nottingham, Nottingham, UK
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Koehlinger KM, Van Horne AJO, Moeller MP. Grammatical outcomes of 3- and 6-year-old children who are hard of hearing. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2013; 56:1701-14. [PMID: 23882004 PMCID: PMC3951012 DOI: 10.1044/1092-4388(2013/12-0188)] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
PURPOSE Spoken language skills of 3- and 6-year-old children who are hard of hearing (HH) were compared with those of children with normal hearing (NH). METHOD Language skills were measured via mean length of utterance in words (MLUw) and percent correct use of finite verb morphology in obligatory contexts based on spontaneous conversational samples gathered from 185 children (145 HH, 40 NH). Aided speech intelligibility index (SII), better-ear pure-tone average (BE-PTA), maternal education, and age of amplification were used to predict outcomes within the HH group. RESULTS On average, the HH group had MLUws that were 0.25-0.5 words shorter than the NH group at both ages, and they produced fewer obligatory verb morphemes. After age, aided SII and age of amplification predicted MLUw. Aided SII and BE-PTA were not interchangeable in this analysis. Age followed by either BE-PTA or aided SII best predicted verb morphology use. CONCLUSIONS Children who are HH lag behind their peers with NH in grammatical aspects of language. Although some children appear to catch up, more than half of the children who are HH fell below the 25th percentile. Continued monitoring of language outcomes is warranted considering that children who are HH are at increased risk for language learning difficulties.
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Muse C, Harrison J, Yoshinaga-Itano C, Grimes A, Brookhouser PE, Epstein S, Buchman C, Mehl A, Vohr B, Moeller MP, Martin P, Benedict BS, Scoggins B, Crace J, King M, Sette A, Martin B. Supplement to the JCIH 2007 position statement: principles and guidelines for early intervention after confirmation that a child is deaf or hard of hearing. Pediatrics 2013; 131:e1324-49. [PMID: 23530178 DOI: 10.1542/peds.2013-0008] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Holt RF, Beer J, Kronenberger WG, Pisoni DB. Developmental effects of family environment on outcomes in pediatric cochlear implant recipients. Otol Neurotol 2013; 34:388-95. [PMID: 23151776 PMCID: PMC3594395 DOI: 10.1097/mao.0b013e318277a0af] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine and compare the family environment of preschool- and school-age children with cochlear implants and assess its influence on children's executive function and spoken language skills. STUDY DESIGN Retrospective between-subjects design. SETTING Outpatient research laboratory. PATIENTS Prelingually deaf children with cochlear implants and no additional disabilities and their families. INTERVENTION(S) Cochlear implantation and speech-language therapy. MAIN OUTCOME MEASURES Parents completed the Family Environment Scale and the Behavior Rating Inventory of Executive Function (or the preschool version). Children were tested using the Peabody Picture Vocabulary Test-4 and either the Preschool Language Scales-4 or the Clinical Evaluation of Language Fundamentals-4. RESULTS The family environments of children with cochlear implants differed from normative data obtained from hearing children, but average scores were within 1 standard deviation of norms on all subscales. Families of school-age children reported higher levels of control than those of preschool-age children. Preschool-age children had fewer problems with emotional control when families reported higher levels of support and lower levels of conflict. School-age children had fewer problems with inhibition but more problems with shifting of attention when families reported lower levels of conflict. School-age children's receptive vocabularies were enhanced by families with lower levels of control and higher levels of organization. CONCLUSION Family environment and its relation to language skills and executive function development differed across the age groups in this sample of children with cochlear implants. Because family dynamics is one developmental/environmental factor that can be altered with therapy and education, the present results have important clinical implications for family-based interventions for deaf children with cochlear implants.
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Affiliation(s)
- Rachael Frush Holt
- Department of Speech and Hearing Sciences, Indiana University, Bloomington, Indiana 47405, USA.
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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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Quittner AL, Cruz I, Barker DH, Tobey E, Eisenberg LS, Niparko JK. Effects of maternal sensitivity and cognitive and linguistic stimulation on cochlear implant users' language development over four years. J Pediatr 2013; 162:343-8.e3. [PMID: 22985723 PMCID: PMC3638743 DOI: 10.1016/j.jpeds.2012.08.003] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 07/17/2012] [Accepted: 08/02/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To examine the effects of observed maternal sensitivity (MS), cognitive stimulation (CS), and linguistic stimulation on the 4-year growth of oral language in young, deaf children receiving a cochlear implant. Previous studies of cochlear implants have not considered the effects of parental behaviors on language outcomes. STUDY DESIGN In this prospective, multisite study, we evaluated parent-child interactions during structured and unstructured play tasks and their effects on oral language development in 188 deaf children receiving a cochlear implant and 97 normal-hearing children as controls. Parent-child interactions were rated on a 7-point scale using the National Institute of Child Health and Human Development's Early Childcare Study codes, which have well-established psychometric properties. Language was assessed using the MacArthur Bates Communicative Development Inventories, the Reynell Developmental Language Scales, and the Comprehensive Assessment of Spoken Language. RESULTS We used mixed longitudinal modeling to test our hypotheses. After accounting for early hearing experience and child and family demographics, MS and CS predicted significant increases in the growth of oral language. Linguistic stimulation was related to language growth only in the context of high MS. CONCLUSION The magnitude of effects of MS and CS on the growth of language was similar to that found for age at cochlear implantation, suggesting that addressing parenting behaviors is a critical target for early language learning after implantation.
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Affiliation(s)
| | - Ivette Cruz
- Departments of Otolaryngology, University of Miami,Departments of Barton G Kids Hear Now Cochlear Implant Family Resource Center, Miami, FL
| | - David H. Barker
- Departments of Division of Child and Adolescent Psychiatry, Rhode Island Hospital, and Department of Psychiatry and Human Behavior, The Alpert Medical School of Brown University, Providence, RI
| | - Emily Tobey
- Departments of University of Texas at Dallas, Callier Center for Communication Disorders, Dallas, TX
| | | | - John K. Niparko
- Department of Otolaryngology, Johns Hopkins University, Baltimore, MD
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