Language Outcomes After Cochlear Implantation

https://doi.org/10.1016/j.otc.2011.08.024Get rights and content

Section snippets

Language acquisition in children with CIs

The primary goal of implantation in children is to facilitate communication in the modality that is native to the families of the vast majority of deaf children: spoken language. Language is defined as a vehicle for shaping and relating abstractions for communication3 in which meaning is independent of the immediate situation. Practical use of speech is based on the assignment of a single name to various appearances and situations under varying conditions. Spoken language involves a conversion

Literacy skills in children with CIs

The nature of a child’s language development, whether manual or oral, will depend on the quantity and quality of exposure to a complete language system. Early and appropriate language stimulation appears to be an important factor in the acquisition of visual language as manifest in comprehension (reading) and expression (writing), as well as in acquisition of spoken language. For example, reading comprehension ability among deaf 15-year-old students who use American Sign Language as their

Auditory rehabilitation after cochlear implantation

The uniqueness of the listening experience enabled by a CI is underscored by qualitative differences in how sound perception is elicited in comparison with other strategies of auditory rehabilitation. For example, a hearing aid filters, amplifies, and compresses the acoustic signal, thereby delivering a processed signal to the cochlea for transduction. By contrast, a CI receives, processes, and transmits acoustic information by generating electrical fields. Electrical stimulation bypasses

Premise 1. The Child Must Learn to Attach Meaning to What is Heard Through the CI

To learn a spoken language via a CI, two conditions must be met. First, the listener must have sufficient (not necessarily perfect) auditory access to the language code—the vowels, consonants, and suprasegmental patterns that make up that language. In other words, one must be able to hear a language to learn it. Auditory access is essential, but not sufficient, for language acquisition. A second, critical condition must also be met: The sounds must gradually be attached to meaning. Attaching

Premise 3. Skills Learned in a Therapy Setting Must be Transferred Out of the Therapy Room and into the Classroom, Home, and Other Aspects of the Child’s Everyday World

Clinicians must develop and practice skills within the therapy room but always with the greater goal that those skills will generalize out of the therapy room, into the child’s classroom, home setting, and other everyday environments.

Studies and clinical experience support the notion that the parents are primary agents in their child’s communicative competence and overall development.48, 49 Clinicians should view their role largely as one of helping parents facilitate their child’s

Premise 6. Almost All Children with CIs Require a Combination of Didactic Instruction and Incidental Learning to Acquire Spoken Language

Auditory development in children with profound deafness has been traditionally viewed as requiring rote training. This viewpoint implied that the child required didactic instruction to achieve each of the listening skills along a hierarchy of auditory development, and virtually hundreds of such skills were required to achieve mastery. The assumption was that the child learned only what was directly taught.

This approach was not unreasonable, given limitations in conveying the highly nuanced

Premise 11. Auditory Milestones that have been Established May be Used to “Red Flag” Children who are Progressing at a Slower than Expected Rate

Research and clinical findings have documented the auditory milestones achieved by the average child with a CI during the first year of device use.11, 30, 55, 56 Three different groups of CI children reflect different preimplant characteristics and show different patterns of skill achievement. When a child is identified as progressing at a slower rate than expected, red flags are raised and specific steps taken, allowing clinicians to intervene as early as possible and identify the source of

First page preview

First page preview
Click to open first page preview

References (58)

  • K. Berliner et al.

    Methods and issues in the cochlear implantation of children: an overview

    Ear Hear

    (1985)
  • D. Ling

    Foundations of spoken language for hearing impaired children

    (1989)
  • R. Jackendoff

    Phonological structure

  • A.M. Robbins

    Rehabilitation after cochlear implantation

  • T. Nikolopolous et al.

    Development of spoken language grammar following cochlear implantation in prelingually deaf children

    Arch Otolaryngol Head Neck Surg

    (2004)
  • M. Svirsky et al.

    Language development in profoundly deaf children with cochlear implants

    Psychol Sci

    (2000)
  • D. Hammes et al.

    Early identification and cochlear implantation: critical factors for spoken language development

    Ann Otol Rhinol Laryngol Suppl

    (2002)
  • J. Niparko et al.

    Spoken language development in children following cochlear implantation

    JAMA

    (2010)
  • J.G. Nicholas et al.

    Will they catch up? The role of age at cochlear implantation in the spoken language development of children with severe to profound hearing loss

    J Speech Lang Hear Res

    (2007)
  • M. Manrique et al.

    Advantages of cochlear implantation in prelingual deaf children before 2 years of age when compared with later implantation

    Laryngoscope

    (2004)
  • A.M. Robbins et al.

    Effect of age at cochlear implantation on auditory skill development in infants and toddlers

    Arch Otolaryngol Head Neck Surg

    (2004)
  • L. Kishon-Rabin et al.

    Developmental aspects of the IT-MAIS in normal-hearing babies

    Isr J Speech Hear

    (2001)
  • A. Sharma et al.

    A sensitive period for the development of the central auditory system in children with cochlear implants: implications for age of implantation

    Ear Hear

    (2002)
  • A. Geers et al.

    Factors associated with development of speech perception skills in children implanted by age five

    Ear Hear

    (2003)
  • J.B. Tomblin et al.

    A comparison of language achievement in children with cochlear implants and children using hearing aids

    J Speech Lang Hear Res

    (1999)
  • A.M. Robbins et al.

    Aspects of linguistic development affected by cochlear implants

  • A. Boothroyd et al.

    Practical implications of CIs in children

    Ear Hear

    (1991)
  • M.J. Osberger

    Language and learning skills of hearing-impaired students

    ASHA Monogr

    (1986)
  • A. Boothroyd et al.

    Auditory speech perception capacity of child implant users expressed as equivalent hearing loss

    Volta Rev

    (1994)
  • K. Eisenberg et al.

    Communication abilities of children with aided residual hearing: comparison with cochlear implant users

    Arch Otolaryngol Head Neck Surg

    (2004)
  • A.M. Robbins

    Language development in children with cochlear implants

  • A. Geers et al.

    Language skills of children with early cochlear implantation

    Ear Hear

    (2003)
  • P.J. Blamey et al.

    Relationships among speech perception, production, language, hearing loss and age in children with impaired hearing

    J Speech Lang Hear Res

    (2001)
  • M. Fey

    Language intervention with young children

    (1986)
  • R. Parrish et al.

    When hearing loss occurs with other disabilities

    Volta Voices

    (2004)
  • C. Yoshinaga-Itano et al.

    Language of early- and later-identified children with hearing loss

    Pediatrics

    (1998)
  • A. Geers

    Speech, language and reading skills after early cochlear implantation

    Arch Otolaryngol Head Neck Surg

    (2004)
  • E. Tyszkiewicz et al.

    Paediatric rehabilitation

  • K.I. Kirk et al.

    New directions in pediatric cochlear implantation: effects on candidacy

    ASHA Leader

    (2006)
  • Cited by (0)

    View full text