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.     

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.     

Cochlear implants for younger children: a preliminary description of the parental decision process and outcomes

The authors conducted a preliminary telephone interview study of a random sample of 35 parents whose children had received cochlear implants through a large-scale implant program. Parents were asked about their child's preimplant and postimplant communications skills, how they learned about implants, and how they arrived at the decision to have their child receive an implant. Results of the interviews suggest, a least for this program, that two types of decision sequences are followed. One type of parent has initial and primary contact through a medical practitioner, uses that source of information exclusively, and is motivated by a desire for a "normal" communication situation. The second type of parent learns about implants from another parent, family member, or teacher. This individual will seek other sources of information and is most often motivated by the child's lack of communication skill. Generally, from parents' perspective, language and speech rather than improved social skills or social contact are the primary benefits of the implant.     

Models of deafness: cochlear implants in the Australian daily press

This article examined a database of Australian daily newspapers on the terms cochlear implant and deaf children to investigate how journalists and columnists report competing models of deafness: as either "medical" (deafness is a condition to be cured) or "sociocultural" (deafness provides a way of life to be lived). The results from the cochlear implant search favored a medical model, but the results from the deaf children search were more balanced, with a slight preponderance of articles favoring the sociocultural model. A number of representative quotes from articles in each model are provided and discussion entered into as to the possible effects of the articles on public reactions to deafness and especially hearing parental responses to the birth of a deaf child and the life choices that this event presents them.     

Verbal information-processing capabilities and cochlear implants: implications for preoperative predictors of speech understanding

In this study, we examined preoperative verbal cognitive capacity in 11 deafened adults who were cochlear implant candidates and reexamined level of speech understanding after 6-8 months' experience with the implant. Verbal cognitive performance in the implant group was compared in a group of normal hearing subjects and in nonimplanted group of deafened adults. The three groups performed on par with each other with an exception: The individuals in the cochlear implant group and the nonimplanted group of deafened adults performed significatly worse than those of normal hearing in tasks in which use of internal speech is a key feature (i.e., rhyme judgement and lexical decision tasks). Postoperative observations of the implanted individuals' level of speech understanding suggest that it is possible to predict the level of speech understanding by means of a properative cognitive assessment. The characteristics of three verbal cognitive abilities prove to be critical indicators of 6 - 8 months' postoperative outcome: internal speech functioning, speed of verval information processing, and working memory capacity - the first factor proved the most decisive. We discuss the results with respect to direct versus indirect predictors of outcomes from cochlear implant operations and the effect of auditory deprivation on deafened adults' capability to process auditory information.     

Improving child welfare through a children's ombudsman.

OBJECTIVE: This report examines the changes in a child welfare system created by establishing an ombudsman's office to investigate complaints regarding children in the foster care, adoption, and child protection systems. METHOD: Serving as a complaint office, the Michigan Office of Children's Ombudsman investigated 443 cases involving 820 children during its first 18 months of operation. Information was collected regarding the nature of abuse and system concerns identified in child protective services, foster care, or adoption agencies from across our state. Information was also collected regarding changes in agency practices or procedures or legislation resulting from case investigation. RESULTS: The Children's Ombudsman in Michigan identified 209 cases in which "administrative acts" of child protective services, foster care, or adoption agencies led to real or potential harm to children. Through investigation of these complaints, a number of areas of concern in the child welfare system were identified, resulting in changes in case management, investigation, or service provision. CONCLUSIONS: A children's ombudsman can improve the child welfare system through complaint investigation and identification of system-wide deficiencies on a state-wide level.     

Individual differences in language performance after cochlear implantation at one to three years of age: child, family, and linguistic factors

Language skills were investigated in a multicultural sample of 13 prelingually deaf children (11 profoundly deaf from birth) who received cochlear implants between 14 and 38 months of age; average duration of implant use was 49 months. Individual postimplant language skills ranged from extremely delayed to age appropriate. On average, skills varied across domains: on vocabulary, several children functioned in the average range compared with hearing peers, but all were below that range on a test emphasizing syntax (CELF-P). Children with preimplant hearing experience had the highest scores on all language measures. Excluding these children, age of implantation (range 14 to 27 months) associated inversely and significantly with CELF-P scores, even when nonverbal IQ was controlled. Qualitative analyses indicated higher child language achievement associated with parents' reports of lengthy, in-depth processes to decide about cochlear implantation. Such reports may indicate high levels of ongoing parent involvement with child and programming.     

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.     

Parental distress: the initial phase of hearing aid and cochlear implant fitting

The results of previous cross-section studies suggest that childhood hearing impairment may lead to parental psychosocial stress. The present study investigated whether modifications in parental psychic state can be ascertained in connection with the child's treatment events and the child's hearing and speech status, in a prospective study design. Data were available on 116 fathers and mothers regarding the pre-cochlear implant examination or hearing aid fitting of their child. In the course of the child's treatment, parental quality of life improved from a low to a normal level. Among children who were at the stage of pre-examination for a cochlear implant, better hearing and speech capacity was linked to more severe impairment of the parental state. It is emphasized that the parents whose children showed comparatively good language development at the time of pre-examination for a cochlear implant were especially subjected to stress.     

Children's emotions and behaviors in response to infants' cries

Infant crying can elicit in others both a range of emotions and contrasting behavioral reactions, such as altruistic caregiving versus aggression. Variations in reactions to young infants' cries were examined in 60 children ranging in age from late preschool to preadolescence. Each child over-heard either a preterm or a full-term tape-recorded cry from an adjacent room. Then a mother, carrying her infant, came looking for her (previously) "crying" infant's bottle. Later each child was interviewed after hearing a tape recording of a preterm and a full-term cry. Children's emotions and behaviors thus were assessed in response to simulated, real distresses and hypothetical representations of distress. Children's self-reports of empathy, their verbalized intentions to help, their actual helping responses, and observers' ratings of negative emotion were common responses to cries at all ages. In addition there were significant increases with age in prosocial, behavioral interventions. Expressions of negative emotion were inversely related to subsequent forms of prosocial behavior that required direct interaction with the infant. The emotions and behaviors of most children were not influenced by whether they heard preterm or full-term cries. They were, however, able to discriminate between such cries and some articulated "theories" about the impact of the cries on the listener.     

Cochlear implants in the inclusive classroom: a case study

This article presents a case study of a child aged 12 years with a cochlear implant who is attending a mainstream educational setting in Skopje, FYR Macedonia. The study, which uses both qualitative and quantitative data, took place over a period of 12 months. It illustrates the importance of professional development and training of teachers and a need to emphasise a range of intervention strategies. It also highlights the challenges facing children and young people with cochlear implants in schools and suggests a range of systemic approaches to addressing the issues raised.     

Literacy skills in children with cochlear implants: the importance of early oral language and joint storybook reading

The goal of this study was to longitudinally examine relationships between early factors (child and mother) that may influence children's phonological awareness and reading skills 3 years later in a group of young children with cochlear implants (N = 16). Mothers and children were videotaped during two storybook interactions, and children's oral language skills were assessed using the "Reynell Developmental Language Scales, third edition." Three years later, phonological awareness, reading skills, and language skills were assessed using the "Phonological Awareness Test," the "Woodcock-Johnson-III Diagnostic Reading Battery," and the "Oral Written Language Scales." Variables included in the data analyses were child (age, age at implant, and language skills) and mother factors (facilitative language techniques) and children's phonological awareness and reading standard scores. Results indicate that children's early expressive oral language skills and mothers' use of a higher level facilitative language technique (open-ended question) during storybook reading, although related, each contributed uniquely to children's literacy skills. Individual analyses revealed that the children with expressive standard scores below 70 at Time 1 also performed below average (<85) on phonological awareness and total reading tasks 3 years later. Guidelines for professionals are provided to support literacy skills in young children with cochlear implants.     

儿童心理理论研究现状与发展趋势

在过去的一二十年里,儿童心理理论的研究是当今发展心理学中最活跃的领域之一,是心理知识发展研究的新趋势。该文介绍儿童心理理论的实验范式及其存在的争议;儿童心理理论的理论模型;概括阐述自儿童心理理论发展以来的几个研究方向和研究结果;并在此基础上预测心理理论的发展动向和新趋势,以期对儿童心理理论发展研究有一个全面的了解。     

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.     

Conflicting Views of Realistic Professionalism: Preservice Educators' Concerns Arising from Analysis of Themes in Their Reflective Writings

Current demands for professionalism from society are great, and future educators are concerned that they do not have the stamina and resources to fulfill their personal roles. This research examines 453 reflective writings of 151 preservice teachers, child and youth care providers, and counselors who, despite being asked to identify how their learning could help children, also wrote about their professional concerns. The 406 expressed concerns were identified based on 86 vocabulary leads. The categories of concern were (a) Misbehaviour, Aggression, Violence, and Victimization, (b) Multiculturalism and Diversity, (c) Personal Preparation and Career Choice, (d) The Responsibility of Providing Appropriate Teaching and Learning Methods, and (e) Appropriate Involvement in Children's Lives. The overall highest concern was for Personal Preparation and Career Choice, although the second highest concern for Misbehavior, Aggression, Violence, and Victimization increased dramatically after a special unit on childhood discipline practices was presented to the participants.     

The Relationship between Children's Emotional and Behavioral Problems and the Social Responses of Elementary School Teachers

This study examined the relationship between children's emotional and behavioral problems and teachers' social responding. Elementary school students completed the Children's Depression Inventory and a parent completed the Child Behavior Checklist. Teachers rated children on measures of interpersonal attractiveness and personal rejection. Teachers' ratings of student interpersonal attractiveness were significantly correlated with the level of student depression, internalizing problems, externalizing problems, and overall psychopathology. However, teachers' ratings of personal rejection toward students only correlated with externalizing behavior problems. Family income was also related to child adjustment and teacher ratings. Externalizing behavior problems best predicted both lower interpersonal attractiveness and increased personal rejection, even after controlling for family income. Copyright 1999 Academic Press.     

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.     

Disciplinary choices of mothers of deaf children and mothers of normally hearing children

OBJECTIVE: To assess the disciplinary preferences of mothers of profoundly deaf children and normally hearing children in a test of the hypothesized link between child disabilities and punitive parenting. METHOD: Disciplinary preferences of mothers seeking a cochlear implant for their profoundly deaf child (n=57), mothers not seeking an implant for their deaf child (n=22), and mothers of normally hearing children (n=27) were assessed using an analog task in which subjects select discipline in response to slide images of children engaging in normative or frankly deviant behaviors that are potentially irritating. RESULTS: Results indicated that mothers of children with profound hearing impairments were more likely to select physical discipline in response to depicted child transgressions and more likely to escalate to physical discipline when the depicted child was described as persisting in the transgression. Additionally, escalation was more probable in response to scenes depicting children engaged in dangerous and destructive acts than in rule-violating acts. CONCLUSIONS: Findings were consistent with the hypothesized link between childhood disabilities and child maltreatment as well as the hypothesis that children with disabilities associated with communication problems could be at risk of physical abuse.