Peer relationships of children with cochlear implants

Previous research on children with cochlear implants has focused mostly on their speech perception and production. With the growing numbers of children who use the implant, it is important to assess other aspects of these children's functioning. This article offers a qualitative and quantitative analysis of interviews with parents who described their children's communication skills and peer relationships before they had the implant and afterward. Results show that the implant has the potential to improve deaf children's relationships with hearing peers. Nonetheless, children with implants still face communication obstacles, which impede their social relationships with hearing peers. Results are discussed in light of the different points of view of various "stake holders" regarding cochlear implants in children.     

The modes of communication used by children with cochlear implants and the role of sign in their lives

In a mixed-methods study, which included surveys of 247 parents and 151 teachers, the researchers investigated the modes of communication used by children with cochlear implants and the role of signed communication in the children's lives. Findings indicated that 15%-20% of the children in the parent surveys and approximately 30% of the children in the teacher surveys were using some form of signed communication. Qualitative findings from interviews with parents, teachers, and children with cochlear implants elaborated on the quantitative findings. While the development of spoken-language communication was the main aim of their children's cochlear implantation for the large majority of parents, many valued the use of either Signed English or Australian Sign Language, which they felt supported their children's personal, social, and academic development. Young people who used sign switched comfortably between communication modes according to their communication partners, topics, and settings.     

Interviews with deaf children about their experiences using cochlear implants

Within the framework of a longitudinal study of deaf children with cochlear implants, 11 children with implants were interviewed. The objective was to shed light on what it is like for a child to use a cochlear implant, based on these children's own experience with implants, which ranged from 5.0 to 7.5 years. Six of the children were in schools for the deaf, five in regular classes. All but one used an implant daily. The children appreciated that an implant enabled them to perceive sounds in the environment. Some of the children in regular classes could take part in one-to-one conversations with teachers but had difficulty following teaching and discussions. This observation was consistent with what the children's parents and teachers had maintained. Peer interaction was said to be best when other children had the use of at least some signs.     

Social participation of children and adolescents with cochlear implants: a qualitative analysis of parent, teacher, and child interviews

Psychosocial factors, including socioemotional well-being, peer relationships, and social inclusion with hearing and deaf peers, are increasingly becoming a focus of research investigating children with cochlear implants. The study reported here extends the largely quantitative findings of previous research through a qualitative analysis of interviews with parents, teachers, and pediatric cochlear implant users themselves in three eastern states of Australia. We interviewed 24 parents, 15 teachers, and 11 children and adolescents. The findings displayed commonalities across the three groups of participants, indicating positive experiences around the children's psychosocial development with their cochlear implants, but also ongoing difficulties communicating in groups of people and problems related to social skills. Some children had little contact with other deaf children (with or without cochlear implants) despite parents and teachers perceiving such contact beneficial. Children attending schools where there were other deaf children valued friendships with both deaf and hearing peers. Adolescence was a particularly difficult time for some as they struggled with feelings of self-consciousness about their deafness and external cochlear implant equipment and worries around friendships, dating, and their future place in the world. Recommendations for practice and further research are made.     

Development of implanted deaf children’s conversational skills

Previous studies of preverbal development have highlighted the recurrent difficulties experienced by deaf children in acquiring knowledge of the social rules and social skills pertaining to discourse. We expected cochlear implants in children with bilateral profound deafness to improve their use of verbal language, so that their communication skill profile resembled that of younger, hearing children. Using conversation samples taken from videos recorded every 6 months over a 2-year period, we monitored the development of communication skills in a group of 18 prelingually profoundly deaf children (mean implantation age, 3 years and 5 months). Results corroborated our hypothesis that the overall communication performances of children with cochlear implants improve, both quantitatively and qualitatively, as early as the first year post-implantation.     

Language codes and sense-making among deaf schoolchildren

There are at least two languages (American Sign Language [ASL], English) and three modalities (sign, speech, print) in most deaf individuals' lives. Mixing of ASL and English in utterances of deaf adults has been described in various ways (pidgins, diglossia, language contact, bilingualism), but children's mixing usually is treated as the 'fault' of poor input language. Alternatively, how might language mixing serve their communication goals? This article describes code variations and adaptations to particular situations. Deaf children were seen to exhibit a wide variety of linguistic structures mixing ASL, English, Spanish, signing, and speaking. Formal lessons supported a recoding of English print as sign and speech, but the children who communicated English speech were the two who could hear speech. The children who communicated ASL were those who had deaf parents communicating ASL or who identified with deaf houseparents communicating ASL. Most language produced by the teacher and children in this study was mixed in code and mode. While some mixing was related to acquisition and proficiency, mixing, a strategy of many deaf individuals, uniquely adapts linguistic resources to communication needs. Investigating deaf children's language by comparing it to standard English or ASL overlooks the rich strategies of mixing that are central to their communication experience.     

Reading comprehension of deaf children with cochlear implants

The reading comprehension and visual word recognition in 50 deaf children and adolescents with at least 3 years of cochlear implant (CI) use were evaluated. Their skills were contrasted with reference data of 500 deaf children without CIs. The reading comprehension level in children with CIs was expected to surpass that in deaf children without implants, partly via improved visual word recognition. Reading comprehension scores of children with implants were significantly better than those of deaf children without implants, although the performance in implant users was substantially lagging behind that in hearing children. Visual word recognition was better in children with CIs than in children without implants, in secondary education only. No difference in visual word recognition was found between the children with CIs and the hearing children, whereas the deaf children without implants showed a slightly poorer performance. The difference in reading comprehension performance of the deaf children with and without CIs remained present when visual word recognition was controlled for. This indicates that other reading-related skills were also contributing to the improved reading comprehension skills of deaf children with CIs.     

Teachers' ratings of functional communication in students with cochlear implants

The study examined factors associated with teachers' ratings of functional communication skills of students with cochlear implants. Deaf students living in and around a metropolitan area were surveyed to locate 51 with cochlear implants. Teachers rated each student's functional use of the implant, given three defined ratings. Additional information regarding sex, communication option, placement, home language, rural or nonrural address, etiology, and presence or absence of an additional disability was gathered. Chi-square analyses of the data were performed. The data indicated that students with a known etiology and a rural address, and who used sign language at home or school, were less likely than others to use the implant as a primary channel for receptive communication. The authors suggest that the teacher's role in implant use warrants more attention. Speech-language pathologists, otologists, audiologists, and parents of deaf children should consider all factors related to successful implant use before advocating or choosing this financially, emotionally, and therapeutically challenging option.     

手势表征对有助听设备聋生语音提取的影响

以17名有人工耳蜗或助听器的初中聋生为被试,考查手势表征对于聋生语音提取 的影响.被试判断同一汉字在不同词语中的读音是否相同.结果表明,聋生的语音判断受 手势信息的干扰.在聋生的语言表征中,语音表征同手势表征联系较强.初中聋生的语言 表征符合修正的层级模型.     

Neuropsychological correlates of vocabulary, reading, and working memory in deaf children with cochlear implants

The performance of deaf children with cochlear implants was assessed using measures standardized on hearing children. To investigate nonverbal cognitive and sensorimotor processes associated with postimplant variability, five selected sensorimotor and visuospatial subtests from A Developmental Neuropsychological Assessment (NEPSY) were compared with standardized vocabulary, reading, and digit span measures. Participants were 26 deaf children, ages 6-14 years, who received a cochlear implant between ages 1 and 6 years; duration of implant use ranged from 3 to 11 years. Results indicated significant correlations between standard scores on the Design Copying subtest of the NEPSY and standard scores on vocabulary comprehension, reading, and digit span measures. The results contribute to our understanding of the benefits of cochlear implantation and cognitive processes that may support postimplant language and academic functioning.     

Cochlear implanted pupils in Scottish schools: 4-year school attainment data (2000-2004)

The Achievements of Deaf Pupils in Scotland (ADPS) project has been tracking the educational attainment of deaf pupils in Scotland's schools since 2000. At the time of writing, the database contains records for 1,752 deaf pupils (2000-2005). Here 4-year aggregate educational attainment data are reported for a subset of 152 school-aged deaf pupils with cochlear implants notified to the ADPS database between June 2000 and June 2004. The data describe primary and secondary school results in reading, writing, and math for this subgroup, as well as placement and communication characteristics. The educational attainment of the group of deaf pupils with cochlear implants is clearly marked when the deaf pupil population is disaggregated for hearing loss, achieving comparatively higher average attainment in both 5-14 Curriculum National Tests (Mathematics in particular) and Standard Grades. Therefore the gap in performance relative to the national population data is reduced for those deaf pupils, although it still widens at higher levels of achievement for the National Tests. Although most pupils with cochlear implants are placed in the mainstream, there is no pattern of migration toward mainstream schools. Some deaf pupils with cochlear implants moved out of mainstream to other types of placement, and this has implications for health-economic cost-utility assessments of cochlear implantation that favor mainstream education by drawing upon the relative cost of different placement types. These findings suggest that the ADPS program of research can contribute school outcome data as valuable real-life outcome measures in wider assessments of the benefit of cochlear implants to deaf children and deaf young people.     

Searching for cochlear implant information on the internet maze: implications for parents and professionals

The present study has three purposes: (a) to determine who disseminates information on cochlear implants on the Web; (b) to describe a representative sample of Web sites that disseminate information on cochlear implants, with a focus on the content topics and their relevance to parents of deaf children; and (c) to discuss the practical issues of Web-based information and its implications for professionals working with parents of deaf children. Using the terms "cochlear implants" and "children," the first 10 sites generated by the four most popular search engines (Google, Yahoo, Microsoft's MSN, and America Online) at two points in time were selected for analysis, resulting in a sample of 31 Web sites. The majority of Web sites represented medically oriented academic departments and government organizations, although a wide variety of other sources containing information about cochlear implants were also located. Qualitative analysis revealed that the content tended to fall into eight categories; however, the important issues of educational concerns, habilitation following surgery, and communication methods were either addressed minimally or neglected completely. Using analytical tools that had been developed to evaluate "user friendliness" in other domains, each Web site was assessed for its stability, service/design features and ease of use. In general, wide variability was noted across the Web sites for each of these factors. The strong recommendation is made that professionals understand and enhance their knowledge of both the advantages and limitations of incorporating the new technology into their work with parents.     

Parents' views on changing communication after cochlear implantation

We sent questionnaires to families of all 288 children who had received cochlear implants at one center in the United Kingdom at least 5 years previously. Thus, it was a large, unselected group. We received 142 replies and 119 indicated that the child and family had changed their communication approach following cochlear implantation. In 113 cases the change was toward spoken language and in 6 cases the change was toward signed communication. Parents were asked to respond to statements about communication with their deaf child, and their responses indicated that parents wanted the most effective means of communication and one that their child would find most useful in the future. Findings that emerged from parents' comments indicated that the change toward greater use of spoken language was child-led and driven by increased audition. Parents also valued the contribution of signed communication.     

Relationships among professionals' knowledge, experience, and expectations regarding cochlear implants

THE PRESENT STUDY examined the relationships between teachers' and communication clinicians' self-reported knowledge on cochlear implants and their expectations of CIs. The authors also explored these professionals' views regarding the child's communication mode, educational setting, and social options following cochlear implantation. The participants were 47 teachers of deaf students and 35 communication clinicians. The results showed that there were no significant differences between the two groups in self-reported knowledge on CI. Both groups knew very little about mapping, costs, or insurance, and reported good knowledge about candidacy. Expectations from CIs were moderate to high, and were significantly related to respondents' knowledge and specific experience with CIs. Most professionals in both groups supported spoken-language communication, individual inclusion, and social exposure to children with normal hearing as well as to children with hearing impairments.     

Deaf children's use of beliefs and desires in negotiation

Although several studies have shown that deaf children demonstrated impaired performances on false-belief tasks, the children's belief understanding appeared intact when asked to explain emotions or behavior. However, this finding does not necessarily indicate a full-fledged theory of mind. This study aimed to investigate deaf children's negotiation strategies in false-belief situations, because situations that require negotiation provide a natural context with a clear motivational aspect, which might appeal more strongly to deaf children's false-belief reasoning capacities. The purpose of this study was to compare the reactions of 11- to 12-year-old deaf and hearing children to scenarios in which a mother, who is unaware of a change in the situation, threatens to block the fulfillment of the child's desire. The results showed that deaf children more often failed to correct the mother's false beliefs. In contrast with hearing children, who frequently left their own desires implicit, deaf children kept stressing their desires as a primary argument, even though the mother could be expected to be fully aware of these desires. Moral claims were used to the same extent by both groups. In general, deaf children more often used arguments that did not provide new information for their conversation partners, including repetitions of the same argument. The results were interpreted in terms of the special needs that are required by the hampered communication between deaf and hearing people as well as in terms of the ongoing discussion regarding theory-of-mind development in deaf children.     

Examining the communication skills of a young cochlear implant pioneer

The purpose of this longitudinal case study was to closely examine one deaf child's experience with a cochlear implant and his speech, language, and communication skills from kindergarten through middle and high school using both developmental and sociocultural frameworks. The target child was one of the first children to receive a cochlear implant in the United States in 1988, when he was 5 years of age. The developmental analysis revealed that prior to receiving a cochlear implant the child demonstrated profound delays in speech and language skill development. His speech and language skills grew slowly during the first 3-4 years following implantation, very rapidly from about 5 through 7 years postimplantation, then slowed to rates that were highly similar to same-age peers with normal hearing. The sociocultural analysis revealed that the child's communicative competence improved; that he used sign language but use of sign language decreased as his oral communication skills improved; that as his oral communication skills improved, the adults talked and directed the topic of conversation less frequently; and that topics became less concrete and more personal over time. The results of this study indicate that we may learn more about how to support children who use cochlear implants by examining what they are saying as well as how they are saying it.     

Stress and coping in families with deaf children

More than 90% of deaf children are born to hearing parents who experience stress, not only in respose to the initial diagnosis, but also in adapting to the unique needs of their deaf child. This article is a selective literature review summarizing information from three fields in order to broaden our understanding of family adaptation to deafness. Discussion includes (1) psychology's model of individual stress and coping (2) family science's model of family stress management, and (3) literature on family adjustment to disability. The last part of the article traces the development of professionals' understanding of the reciprocal influences between deaf children and their families and describes recent research indicating that the impact of deafness on families is complex and variable. The final conclusion is that adoption of a family stress and coping paradigm would inform discussion of current issues in deafness, such as cochlear implants and bilingualism/biculturalism.     

Children with cochlear implants and complex needs: a review of outcome research and psychological practice

In recent years, the number of children receiving cochlear implants who have significant disabilities in addition to their deafness has increased substantially. However, in comparison with the extensive literature on speech, language, and communication outcomes following pediatric implantation in children without complex needs, the available literature for this special group of children is relatively sparse. This article reviews the available research on outcomes, grouping studies according to the nature of the additional disabilities and specific etiologies of deafness. The methodological problems relating to outcome research in this field are outlined, followed by some tentative conclusions drawn from the literature base while bearing these problems in mind. The remainder of the article focuses on the challenges for clinical practice, from a psychological perspective, of implanting deaf children with complex needs. Two groups of children are considered, those whose additional disabilities have been identified prior to implantation and those whose difficulties become apparent at some point afterward, sometimes many years later. A case example describing the psychological assessment of a deaf-blind child being considered for implantation is presented.     

Long-term predictors of narrative skill in children with early bilateral cochlear implants

Narratives require the integration of many different linguistic skills and can be used as an ecologically valid measure of child language development. This study investigated the narrative skills of 18 six- to seven-year-old prelingually deaf children who received simultaneous bilateral cochlear implants (CI) between 5 and 18 months of age. No significant differences were found on any of the narrative measures between this group and a matched group of normal-hearing children. Measures taken of the children at 3, 6, 9, 12, 24, 36 and 48 months post-implantation, and measures from their parents were examined as possible predictors of narrative skills 72 months post-implantation. Child auditory skills, expressive language and receptive language were significant predictors of later narrative skills. A greater use of auditory-verbal language relative to visually supported language by parents and educators was associated with increased language complexity in child narratives. These results strongly suggest that early bilateral CI is associated with improved language outcomes for children with severe congenital hearing loss.     

Parents' and teachers' evaluations of the communicative abilities of deaf children

The authors compared evaluations by parents and teachers of the communicative abilities of deaf children. Such comparisons between parents' and professionals' assessments of the language development of children who are deaf can provide useful information on which to base ecologically valid intervention approaches. A secondary interest of the authors was to investigate the possible influences on language development of gender, the presence or absence of cochlear implantation, and communication modality (i.e., auditory-verbal or bilingual). The study included the mothers and teachers of 14 deaf children educated in auditory-verbal or bilingual programs. Two scales from a survey instrument, Profiles of the Hearing Impaired (Webster & Webster, 1995), were used. No significant differences between the teachers' and parents' evaluations were found. Gender, cochlear implantation, and communication modality were found to have no significant effect on the evaluations.