Age at implantation and development of vocal and auditory preverbal skills in implanted deaf children
M.E. Taita, T.P. Nikolopoulosb, , and M.E. Lutmanc
a The Ear Foundation, Nottingham, United Kingdom
b Department of Otorhinolaryngology, Athens University, Greece
c Institute of Sound and Vibration Research, University of Southampton, United Kingdom
Received 13 September 2006; revised 16 December 2006; accepted 18 December 2006. Available online 18 January 2007.
Preverbal vocal and auditory skills are essential precursors of spoken language development and they have been shown previously to predict later speech perception and production outcomes in young implanted deaf children.
To assess the effect of age at implantation on the development of vocal and auditory preverbal skills in implanted children.
The study assessed 99 children, 33 in each of three groups (those implanted between 1 and 2 years; 2 and 3 years; and 3 and 4 years). Preverbal skills were measured in three areas: turn taking, autonomy and auditory awareness of spoken language, using the Tait video analysis method.
The youngest implanted group made an exceptional progress outperforming in all measures the two other groups (p <>
Keywords: Language development; Speech perception; Cochlear implant; Prediction; Vocal; auditory; Communication; Preverbal; Observation; Interaction; Deaf; Children; Outcome
Thursday, 18 January 2007
A thought that crossed my mind - actually, it didn't cross, it got caught, is that the way we look at children with CI might be wrong. Wrong in the sense of what kind of support we give compared to the support they need.
Historically, CI's were the next step from HA's. And with that, CI's are many times still regarded as such. A hearing aid. Working in a different way, but still, an aid to hear.
People with CI are therefore still regarded as Hard-of-hearing since "obviously" they use an aid to hear.
This might very well be true in many cases, but a new generation CI-users is emerging. Children that are implanted (often on two sides) before the age of three that do not conciously grow up deaf. CI is giving them sound that enables them to speak and understand language.
The "problem" these children have is not lack of hearing. They hear very soft sounds, they understand and reply with whisper. In that sence they are not hearing impaired. (Keep in mind... I have Lotte in mind. I know results can be different.)
They ARE however behind in language and therefore cognitive thinking. The older the child, (1, 2, 3 years old) the more this is true. This is where the supportsystem should focus! On gaining on the lost language. Because language defines us.
Obviously, the situation depends from child to child. 1 CI will make undrestanding in noisy environment much more difficult, and with that, there is a hearing impairement. But think of children that do well with bi-lateral CI. These children need language, speech and above all, comprehension.
Lotte is now in an all-hearing kindergarten, and with the language she has, she is behind compared to other 4-year olds. (We are not worried about that. She only has two years of sound, so obviously she's behind - and catching up nicely...) She is not able to master communication with children that otherwise would be her "equal" because the others do not understand her. The result is that she will look for other children that either ar younger but at her speech level, or children that are more fysical that communicative. (e.g. boys, playing outside... where screaming and actions goes a long way.)
Focus should be on making sure Lotte is understand. (And this is being done in her kindergarden..)
It seems that for the children, focus is actually on communication and speech.
But what about the parents...
In Norway, the parents are offered sign-laguage classes free of charge. BUT, the focus is only on that. Sign. WE, Lotte's parents, do not have a need for that. Lotte does not use it any more. We need information in speech and language development. How does it work. What are the milestones... What to look for, how to play, what to do, what NOT to do.
BUT since children with CI are still looked at through "DEAF" glasses instead of "Language deprived" glasses, that support is not available. Only "DEAF" therefore "Sign" support...
How is that elsewhere..??
Is the support sysem different.
Like, AV-therapy. It's not available here in Norway, but I have a feeling that there the focus is on educating the parent.... Correction, it's not available where we live..
Anyway... have to do some more research on it.
- 2012-08: Grade 5
- 2011-08: Grade 4
- 2011-03: BTE's on the ear
- 2010-08: Grade 3
- 2009-08: Grade 2
- 2008-08: Mainstream School (6y. old)
- 2006-10: All-hearing Kindergarten (4y. old)
- 2004-11-22: CI activated (27 m. old)
- 2004-10-04: Bi-lateral CI (26 m. old)
- 2003-08: Deaf/HOH/CI Pre-school/"DEAF" Kindergarten (12m. old)
- 2003-07: HA's fitted (11 m. old)
- 2003-06: Diagnosed deaf. Start sign-language (10m. old)
- 2002-11: Suspicion loss of hearing (4 m. old)
- 2002-08: Born - A fierce LION