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Purpose: The aim of this study was to evaluate whether families of children with sensorineural hearing loss (SNHL) are organized similarly to those of typically developing, typically hearing (TH) children and whether the dimensions of family dynamics and environment are related to spoken language development similarly in children with and without SNHL. Method: Primary caregivers of children with SNHL (n = 63) or TH (n = 65) completed the Family Environment Scale-Fourth Edition (FES-4) to assess multiple dimensions of family environment. Children's receptive vocabulary was assessed with the Peabody Picture Vocabulary Test-Fourth Edition, and their receptive language was assessed by an age-appropriate version of the Concepts and Following Directions subtest of the Clinical Evaluation of Language Fundamentals and the Sentence Comprehension subscale of the Comprehensive Assessment of Spoken Language-Second Edition. Principal component analysis was used to examine the dimensional structure of the family environment. Results: Three higher order components were derived from FES-4 subscales for both families of children with SNHL and with TH: Supportive, Controlling, and Conflicted. However, the composition of the factors themselves differed between the two groups. For the tH group, most family environment measures on the FES-4 were not associated with language outcomes. In contrast, for children with SNHL, families who were more supportive, less controlling, and less conflicted had children with better language skills. Conclusions: Three well-accepted dimensions of family dynamics and functioning apply to families of children with SNHL, but their composition differs from those of families with TH children. Family environmental dynamics were much more strongly associated with language outcomes in children with SNHL than in their TH peers. The spoken language development of children with SNHL, in particular, is better in families that provide high levels of support for each other and, in particular, low levels of control, disorganization, and conflict, reflecting the fragile nature of their spoken language development., The family is a central influence on many domains of child development, including socioemotional, language, and cognition (e.g., Belsky, 1981). Attempts to identify dimensions of family dynamics and environment that [...]

Purpose: The purpose of this study was to characterize the acoustic profile and to evaluate the intelligibility of vowel productions in prelingually deafened, Mandarin-speaking children with cochlear implants (CIs). Method: Twenty-five children with CIs and 20 age-matched children with normal hearing (NH) were recorded producing a list of Mandarin disyllabic and trisyllabic words containing 20 Mandarin vowels [a, i, u, y, [??],[??],[??], ai, ei, ia, ie, ye, ua, uo, au, ou, iau, iou, uai, uei] located in the first consonant-vowel syllable. The children with CIs were all prelingually deafened and received unilateral implantation before 7 years of age with an average length of CI use of 4.54 years. In the acoustic analysis, the first two formants (F1 and F2) were extracted at seven equidistant time locations for the tested vowels. The durational and spectral features were compared between the CI and Nh groups. In the vowel intelligibility task, the extracted vowel portions in both NH and CI children were presented to six Mandarin-speaking, NH adult listeners for identification. Results: The acoustic analysis revealed that the children with CIs deviated from the NH controls in the acoustic features for both single vowels and compound vowels. The acoustic deviations were reflected in longer duration, more scattered vowel categories, smaller vowel space area, and distinct formant trajectories in the children with CIs in comparison to NH controls. The vowel intelligibility results showed that the recognition accuracy of the vowels produced by the children with CIs was significantly lower than that of the NH children. The confusion pattern of vowel recognition in the children with CIs generally followed that in the NH children. Conclusion: Our data suggested that the prelingually deafened children with CIs, with a relatively long duration of CI experience, still showed measurable acoustic deviations and lower intelligibility in vowel productions in comparison to the NH children., Vowels and consonants are the two basic types of speech sounds. In most cases, a vowel is a must-have component in a syllable, always occupying the nucleus position. A large [...]

Purpose: To evaluate joint engagement (JE) in age-matched children with and without hearing and its relationship to oral language skills. Method: Participants were 180 children with severe-to-profound hearing loss prior to cochlear implant surgery, and 96 age-matched children with normal hearing; all parents were hearing. JE was evaluated in a 10-minute videotaped free play task with parents. Engagement states ranged from the lowest (unengaged) to the highest level (symbol-infused coordinated). Standardized language measures were administered. Results: Multivariate analyses were conducted between the groups, stratified by chronological and language age. Children who were deaf (Deaf) spent less time in total symbol-infused JE than children with normal hearing (NH) across all ages. The majority of the Deaf group (83%) fell in the lowest language age group, in comparison to 35% of the NH group, and spent significantly less time in symbol-infused JE than hearing children. These delays were also observed in the Deaf group, who fell into the 18-36 month language age. No children in the Deaf group had achieved a language age of > 36 months. Conclusions: Young children with and without hearing had different developmental trajectories of JE, which were related to oral language skills. Key Words: cochlear implants, children, joint engagement, hearing loss, language, A considerable body of literature suggests that joint engagement between a parent and child develops in the first 3 years of life (Adamson, Bakeman, & Deckner, 2004). This developmental process [...]

Purpose: To evaluate the family environments of children with cochlear implants and to examine relationships between family environment and postimplant language development and executive function. Method: Forty-five families of children with cochlear implants completed a self-report family environment questionnaire (Family Environment Scale--Fourth Edition; Moos & Moos, 2009) and an inventory of executive function (Behavior Rating Inventory of Executive Function [Gioia, Isquith, Guy, & Kenworthy, 2000] or Behavior Rating Inventory of Executive Function--Preschool Version [Gioia, Espy, & Isquith, 2003]). The authors also evaluated children's receptive vocabulary (Peabody Picture Vocabulary Test--Fourth Edition; Dunn & Dunn, 2007) and global language skills (Preschool Language Scale--Fourth Edition [Zimmerman, Steiner, & Pond, 2002] and Clinical Evaluation of Language Fundamentals--Fourth Edition [Semel, Wiig, & Secord, 2003]). Results: The family environments of children with cochlear implants differed from those of normal-hearing children but not in clinically significant ways. Language development and executive function were found to be atypical but not uncharacteristic of this clinical population. Families with higher levels of self-reported control had children with smaller vocabularies. Families reporting a higher emphasis on achievement had children with fewer executive function and working memory problems. Finally, families reporting a higher emphasis on organization had children with fewer problems related to inhibition. Conclusion: Some of the variability in cochlear implantation outcomes that have protracted periods of development is related to family environment. Because family environment can be modified and enhanced by therapy or education, these preliminary findings hold promise for future work in helping families to create robust language-learning environments that can maximize their child's potential with a cochlear implant. Key Words: cochlear implant, children, executive function, language, family environment, Most of the research on family factors related to children's success after cochlear implantation has focused on the use of oral language at home, provision of support, the family's role [...]

INTEGRATION EXPERIENCES of hearing impaired German elementary school students in separate educational settings (n = 31) were compared with those of counterparts at the same level in integrated settings (n = 26), and evaluated in regard to psychosocial behavior, semantic-lexical abilities, and communicative skills. Analysis of questionnaire responses and intelligence subtests showed that the only difference between the samples concerned perceived well-being in school, and favored the integrated students. Other percentages of variance are explainable by school type (10%), parents' hearing status (12%), and use of bimodal communication (11%). The integrated students demonstrated a higher level of integration experience, associated with fewer psychosocial abnormalities and better communicative skills. The results indicate that educational setting is not the only factor influencing students' perceived well-being. Other contextual factors, e.g., hearing status of parents and communicative skills, have a similar positive impact on integration experiences

14 mothers of children who were deaf or hard of hearing provided magnitude estimation scaling responses for the speech intelligibility and speech annoyance of narrative speech samples produced by children who were deaf or hard of hearing. Analysis indicated that listeners scaled intelligibility and annoyance the same. As samples became more difficult to understand, they also became more annoying to these listeners. Implications for further research are discussed.

Researchers examined the literature concerning the role of parent-child communication in the development of deaf children. Visual-spatial methods of interacting develop naturally between a deaf child and a deaf parent but more than 90% of deaf children have hearing parents. Research indicates that the social and emotional development of deaf children with hearing parents will be inversely related to the level of hearing loss. Many studies indicate the value to the child's social and emotional development of developing visual and tactile communication techniques.

Preschoolers divided equally between hearing and deaf or hard-of-hearing who all knew each other preferred to interact with same-hearing status peers, but 63% communicated with other-hearing status children, in a recent study. The results suggest that deaf and hard-of-hearing children gain the greatest social and educational benefits when they interact all day at school with hearing peers on an equal basis.

ABSTRACT. The study examined the effects of two interventions on the peer social interaction of 105 young children with and without hearing impairments. Total positive peer interaction and interaction of children with peers of different hearing status increased from preintervention to postintervention but decreased after the intervention was withdrawn. The integrated-activities intervention resulted in greater gains in total positive peer interaction than the social skills intervention. Children with hearing impairments interacted as frequently with their same-status peers as did the children without hearing impairments with their same-status peers. Results indicate the benefits of long-term interventions conducted within small, stable groups of children with and without hearing impairments., Social interaction with peers is an important component of the socialization of all young children and eventually becomes a major influence in their lives (Guralnick, 1986). Peer interaction presents children [...]

Children who are hearing-impaired experience social and cognitive isolation from their family and from the larger community. Children who are hearing-impaired are at risk for behavioral problems, such as hyperactivity, aggression, social incompetence and immaturity. The association between aspects of family functioning (family cohesion, family adaptability, parental emotional adjustment and family stress) and how well the child has adjusted to the hearing impairment, both socially and behaviorally, was studied among 75 hearing-impaired youths and their parents. The relationship between these key aspects was determined after adjusting for demographic features and the degree of hearing loss and method of communication used. Hearing-impaired children who lived in highly structured, rigid and inflexible family environments were more likely to experience behavioral problems. Mothers who were emotionally unstable were more likely to report behavioral problems. The association between the father's emotional symptomology and the child's behavioral problems was not as strong. The child's social competence was predicted by the mother's perception of family stress. It is unclear, however, whether social incompetence exacerbates stress or the reverse. When the degree of hearing loss and communication mode were adjusted for, the major aspects of family functioning became less significant factors. It is concluded that the emotional state of the parents, the adaptability of the family, and the stress experienced in the family contribute to behavioral problems in the hearing-impaired youths. Flexibility in family structure rather than increased structure will help to promote social competence among these children. (Consumer Summary produced by Reliance Medical Information, Inc.)

Previous research has suggested that the normal development of communicative functions proceeds from the directing or `instrumental' types to the informative or "heuristic" types with age. This paper describes a cross-sectional study of communicative function in children with profound hearing loss and children with normal hearing, from ages 12-54 months. The children with hearing loss were learning spoken English as their primary means of communication. The primary purpose of the study was to evaluate whether the pattern of age differences seen in the two groups of children (those with and without normal hearing) are similar patterns that occur at differing chronological ages, or whether they are dissimilar patterns altogether. A second purpose was to examine the relationship between the use of informative/heuristic functions and the acquisition of vocabulary and syntax. The data suggested a somewhat different pattern of communicative function development in children with and without hearing loss. In addition, the use of language for social purposes was closely related to the achievement of traditional language milestones. In both normally hearing children and in those with hearing loss, the correlations between the use of informative-heuristic functions and various measures of language development indicated that the more mature uses of language co-occur with increased frequency of communication, larger vocabulary, and longer utterance length. These results document that when linguistic improvements such as increasing vocabulary size and sentence length occur in deaf children learning spoken English, they are used for appropriate and informative social purposes that are commensurate with their language age. KEY WORDS: deafness, communicative functions, communicative intentions, pragmatics, hearing loss, One sign of increasing maturity of language use in children is the expression of an ever-larger variety of communicative functions. Directing behavior, protesting, making statements, calling attention, and providing and [...]