Cochlear Implant in the Second Year of Life: Lexical and Grammatical Outcomes

Istituto di Scienze e Tecnologie della Cognizione, Consiglio Nazionale delle Ricerche (CNR), Rome, Italy.
Journal of Speech Language and Hearing Research (Impact Factor: 2.07). 01/2012; 55(2):382-94. DOI: 10.1044/1092-4388(2011/10-0248)
Source: PubMed


The authors studied the effect of the cochlear implant (CI) on language comprehension and production in deaf children who had received a CI in the 2nd year of life.
The authors evaluated lexical and morphosyntactic skills in comprehension and production in 17 Italian children who are deaf (M = 54 months of age) with a CI and in 2 control groups of children with normal hearing (NH; 1 matched for chronological age and the other whose chronological age corresponded to the duration of CI activation). The authors also compared children with unilateral CI to children with bilateral CI.
Children with CI appeared to keep pace with NH children matched for time since CI activation in terms of language acquisition, and they were similar to same-age NH children in lexical production. However, children with CI showed difficulties in lexical comprehension when a task required phonological discrimination as well as in grammar comprehension and production. Children with bilateral CI showed better comprehension than did children with unilateral CI; the 2 groups were similar for production.
Activation of CI in the 2nd year of life may provide children who are deaf with a good opportunity to develop language skills, although some limitations in phonological and morphological skills are still present 3 years after auditory reafferentation.

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    • "Spoken language comprehension was assessed at 24, 36 and 60 months post implantation, with the Dutch version of the Reynell Developmental Language Scales [22]. This standardized test was administered by speech and language therapists. "
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    ABSTRACT: This study aimed to evaluate the long term effects of CI on auditory, language, educational and social-emotional development of deaf children in different educational-communicative settings. The outcomes of 58 children with profound hearing loss and normal non-verbal cognition, after 60 months of CI use have been analyzed. At testing the children were enrolled in three different educational settings; in mainstream education, where spoken language is used or in hard-of-hearing education where sign supported spoken language is used and in bilingual deaf education, with Sign Language of the Netherlands and Sign Supported Dutch. Children were assessed on auditory speech perception, receptive language, educational attainment and wellbeing. Auditory speech perception of children with CI in mainstream education enable them to acquire language and educational levels that are comparable to those of their normal hearing peers. Although the children in mainstream and hard-of-hearing settings show similar speech perception abilities, language development in children in hard-of-hearing settings lags significantly behind. Speech perception, language and educational attainments of children in deaf education remained extremely poor. Furthermore more children in mainstream and hard-of-hearing environments are resilient than in deaf educational settings. Regression analyses showed an important influence of educational setting. Children with CI who are placed in early intervention environments that facilitate auditory development are able to achieve good auditory speech perception, language and educational levels on the long term. Most parents of these children report no social-emotional concerns. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    International journal of pediatric otorhinolaryngology 03/2015; 79(6). DOI:10.1016/j.ijporl.2015.03.014 · 1.19 Impact Factor
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    • "Second, the utterances of CI children may contain more speech errors, making the mothers more alert to correct them. CI children have been shown to make more phonological errors than their NH peers [37]. Mothers of CI children therefore may use more reproductive replies in their feedback than NH mothers [38] [39]. "
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    ABSTRACT: Objectives: This study targets to analyse mother-child interactions in two groups of children with different hearing levels: normally hearing children (NH) and congenitally hearing-impaired children with a cochlear implant (CI). Mothers of hearing-impaired children are shown to use less speech in interactions with their children than mothers of normally hearing children. We aim to investigate whether this observation also holds for mothers of CI children. Methods: Transcriptions of spontaneous conversations of ten CI children and ten NH children were analysed. We examined whether mothers responded to their children's utterances and whether they repeated or incorporated them in their own follow-up. Conversations were analysed in two consecutive stages, namely a prelexical stage and a lexical one. Results: Mothers of CI children responded significantly more often to their children's utterances in both the prelexical and lexical stage. They also incorporated their children's utterances more often, however this was only significant in the lexical stage. The type of child utterance was an important trigger for the amount of mothers' responses. All mothers responded significantly more often to lexical utterances in the lexical stage. In the prelexical stage, however, precanonical utterances received the same amount of responses as canonical babbles. Nevertheless, all mothers incorporated canonical babbles more often than precanonical vocalisations in the prelexical stage and lexical utterances more often in the lexical stage. Conclusions: First, mothers of CI children are more responsive to their children's utterances suggesting that they are aware of their children's hearing status. Second, type of child utterance is an important trigger for both mothers' response level and mothers' type of response in the prelexical and lexical stage.
    International Journal of Pediatric Otorhinolaryngology 01/2015; DOI:10.1016/j.ijporl.2015.01.020 · 1.19 Impact Factor
    • "Children seem to do particularly well in tests of vocabulary and less well in tests of productive syntax and morphology (Caselli, Rinaldi, Varuzza, Giuliani & Burdo, 2012b; Duchesne, Sutton & Bergeron, 2009; Geers et al., 2009; Niparko, Tobey, Thal, Eisenberg, Wang, Quittner & Fink, 2010). Some studies have shown that deaf children with CI reach higher linguistic skills than deaf children with traditional hearing aids in receptive language outcomes (Baldassari, Schmidt, Schubert, Srinivasan, Dodson & Sismanis, 2009) and similar to that of hearing children whose chronological age corresponds to the time elapsed since CI activation (Caselli et al., 2012b). Exposure to signs has been identified as a factor that influences spoken language outcome. "
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    ABSTRACT: To address the negative effects of deafness on spoken language acquisition, many clinicians suggest using cochlear implant (CI) and oral education and advise against sign language, even when combined with spoken language (i.e., bilingualism), believing that it may slow down spoken language development. In a deaf child with CI who was exposed at an early age to Italian Sign Language and spoken Italian, we evaluated language development and the relationship between the two languages. The number of words/signs produced by the child consistently increased with age, and the vocabulary growth rate in spoken Italian was equivalent to that of hearing peers. Before CI, the child relied almost exclusively on sign language; after CI, he gradually shifted to spoken Italian yet still used sign language when unable to retrieve words in spoken Italian. We conclude that bimodal bilingualism may scaffold the development of spoken language also in deaf children with CI.
    Bilingualism 10/2014; 17(04):798-809. DOI:10.1017/S1366728913000849 · 1.71 Impact Factor
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