Vocal Development in Infants and Toddlers With Bilateral Cochlear Implants and Infants With Normal Hearing.

Purpose The purpose of this study was to investigate the time course of vocal development in infants and toddlers with bilateral cochlear implants (CIs; bilateral CI group) who are acquiring Finnish and to compare their progress to that of infants with normal hearing and typical development (TD group). Method Five thousand nine hundred sixty-four spontaneous utterances of 30 infants and toddlers (15 in both groups) were classified as either precanonical (PC) vocalizations, basic canonical syllables (BCS), or advanced forms (AF) levels. Time course of development and group differences were analyzed in a prospective longitudinal study during a time course of 1 year: before implantation and 1, 3, 6, 9, and 12 months after CI activation for the bilateral CI group and at 6, 9, and 12 months of age for the TD group.

Grammatical Abilities in Young Cochlear Implant Recipients and Children With Normal Hearing Matched by Vocabulary Size.

Purpose: This study sought to expand understanding of the impact of cochlear implantation on grammatical acquisition by comparing young children who have vocabularies of comparable size. Two research questions were investigated: (a) Do young cochlear implant (CI) recipients have grammatical skills comparable to those of children with normal hearing (NH) matched by spoken vocabulary size? (b) Do these groups show associations between vocabulary size and grammatical measures?

Method: The participants included 13 CI recipients at 24 months postactivation (chronological ages = 33-60 months; M = 44.62) and 13 children with NH between 27 and 30 months old (M = 20.

Consonant Acquisition in Young Cochlear Implant Recipients and Their Typically Developing Peers.

Purpose: Consonant acquisition was examined in 13 young cochlear implant (CI) recipients and 11 typically developing (TD) children.

Method: A longitudinal research design was implemented to determine the rate and nature of consonant acquisition during the first 2 years of robust hearing experience. Twenty-minute adult-child (typically a parent) interactions were video and audio recorded at 3-month intervals following implantation until 24 months of robust hearing experience was achieved.

Can children substitute for adult listeners in judging the intelligibility of the speech of children who are deaf or hard of hearing?

Purpose: Assessments of the intelligibility of speech produced by children who are deaf or hard of hearing (D/HH) provide unique insights into functional speaking ability, readiness for mainstream classroom placements, and intervention effectiveness. The development of sentence lists for a wide age range of children and the advent of handheld digital recording devices have overcome two barriers to routine use of this tool. Yet, difficulties in recruiting adequate numbers of adults to judge speech samples continue to make routine assessment impractical.

Relationships between vocalization forms and functions in infancy: preliminary implications for early communicative assessment and intervention.

Purpose: This preliminary study explored relationships between form and function in prelinguistic vocalizations to increase our understanding of early communicative development and to provide potential clinical implications for early communicative assessment and intervention.

Method: Twenty typically developing infants-5 infants in each of 4 age groups, from 3 to 20 months of age-were included. Vocalizations from these infants had previously been categorized for their form (Nathani, Ertmer, & Stark, 2006) and function (Stark, Bernstein, & Demorest, 1993) characteristics.

Beginning to talk like an adult: increases in speech-like utterances in young cochlear implant recipients and typically developing children.

Purpose: Speech-like utterances containing rapidly combined consonants and vowels eventually dominate the prelinguistic and early word productions of typically developing (TD) toddlers. It seems reasonable to expect a similar phenomenon in young recipients of cochlear implants (CIs). The authors of this study sought to determine the number of months of robust hearing experience needed to achieve a majority of speech-like utterances in both of these groups.

The development of falling intonation in young children with cochlear implants: a 2-year longitudinal study.

This article describes the development of intonation in 12 cochlear implant (CI) recipients. In a previously reported study of the first year of CI use, children who were implanted late (after 24 months) acquired intonation more rapidly than the younger participants. The older children's advantage is plausibly owing to their greater maturity.

Consonant production accuracy in young cochlear implant recipients: developmental sound classes and word position effects.

Purpose: To compare young cochlear implant (CI) recipients' consonant production accuracy with that of age- and gender-matched peers who were typically developing (TD). In addition to examining initial consonants, the authors compiled new data regarding the accuracy of final consonants and the order of consonant acquisition.

Methods: Eleven young CI recipients with 24 months of CI experience and 11 age- and gender-matched TD peers produced target words in short sentences.

Monitoring progress in vocal development in young cochlear implant recipients: relationships between speech samples and scores from the Conditioned Assessment of Speech Production (CASP).

Purpose: To determine the concurrent validity of the Conditioned Assessment of Speech Production (CASP; Ertmer & Stoel-Gammon, 2008) and data obtained from speech samples recorded at the same intervals.

Method: Nineteen children who are deaf who received cochlear implants before their 3rd birthdays participated in the study. Speech samples and CASP scores were gathered at 6, 12, 18, and 24 months postactivation.

Children's development of intonation during the first year of cochlear implant experience.

This article describes the longitudinal development of intonation in 18 deaf children who received cochlear implants (CIs) before the age of 3 years and 12 infants with typical development (TD) who served as controls. At the time their implants were activated, the children with CIs ranged in age from 9 to 36 months. Cross-group comparisons were made when the children had equivalent amounts of robust hearing experience but different chronological ages.

Prelinguistic vocal development in young cochlear implant recipients and typically developing infants: year 1 of robust hearing experience.

This investigation examined the time course and sequence of prelinguistic vocal development during the first year of cochlear implant (CI) experience. Thirteen children who were implanted between 8 and 35 months and 11 typically developing (TD) infants participated in this longitudinal study. Adult-child play interactions were video- and audio-recorded at trimonthly intervals for each group, and child utterances were classified into categories representing progressively more mature productions: Precanonical Vocalizations, Basic Canonical Syllables, and Advanced Form vocalizations.

Speech production accuracy and variability in young cochlear implant recipients: comparisons with typically developing age-peers.

Purpose: The speech production accuracy and variability scores of 6 young cochlear implant (CI) recipients with 2 years of device experience were compared with those of typically developing (TD) age-peers.

Method: Words from the First Words Speech Test (FWST; Ertmer, 1999) were imitated 3 times to assess the accuracy and variability of initial consonants, vowels, and words. The initial consonants in the 4 sets of the FWST followed a typical order of development.

Assessing speech intelligibility in children with hearing loss: toward revitalizing a valuable clinical tool.

Background: Newborn hearing screening, early intervention programs, and advancements in cochlear implant and hearing aid technology have greatly increased opportunities for children with hearing loss to become intelligible talkers. Optimizing speech intelligibility requires that progress be monitored closely. Although direct assessment of intelligibility has been a cumbersome undertaking, advancements in digital recording technology and expanded strategies for recruiting listener-judges can make this tool much more practical in contemporary school and clinical settings.

Relationships between speech intelligibility and word articulation scores in children with hearing loss.

Purpose: This investigation sought to determine whether scores from a commonly used word-based articulation test are closely associated with speech intelligibility in children with hearing loss. If the scores are closely related, articulation testing results might be used to estimate intelligibility. If not, the importance of direct assessment of intelligibility is reinforced.

Characteristics of the transition to spoken words in two young cochlear implant recipients.

Purpose: This investigation addressed two main questions: (a) How do toddlers' spoken utterances change during the first year of cochlear implant (CI) use? and (b) How do the time-courses for reaching spoken word milestones after implant activation compare with those reported for typically developing children? These questions were explored to increase understanding of early semantic development in children who receive CIs before their second birthdays.

Methods: Monthly recordings of mother-child interactions were gathered during the first year of CI use by a boy and a girl whose CIs were activated at 11 and 21 months of age, respectively. Child utterances were classified as nonwords, pre-words, single words, or word combinations, and the percentages of these utterance types were calculated for each month.

Profiles of vocal development in young cochlear implant recipients.

Purpose: The main purpose of this investigation was to examine the effects of cochlear implant experience on prelinguistic vocal development in young deaf children. Procedure A prospective longitudinal research design was used to document the sequence and time course of vocal development in 7 children who were implanted between 10 and 36 months of age. Speech samples were collected twice before implant activation and on a monthly basis thereafter for up to 2 years.

Assessing vocal development in infants and toddlers.

The purpose of this study was to examine changes in prelinguistic vocal production during the first 20 months of life. Vocalizations were classified into 23 mutually exclusive and exhaustive types, and grouped into five ascending levels using the Stark Assessment of Early Vocal Development-Revised (SAEVD-R). Data from 30 typically developing infants, aged 0-20 months, show that older infants attained higher developmental levels on the SAEVD-R than younger infants.

How well can children recognize speech features in spectrograms? Comparisons by age and hearing status.

Real-time spectrographic displays (SDs) have been used in speech training for more than 30 years with adults and children who have severe and profound hearing impairments. Despite positive outcomes from treatment studies, concerns remain that the complex and abstract nature of spectrograms may make these speech training aids unsuitable for use with children. This investigation examined how well children with normal hearing sensitivity and children with impaired hearing can recognize spectrographic cues for vowels and consonants, and the ages at which these visual cues are distinguished.

Beginning to communicate after cochlear implantation: oral language development in a young child.

This longitudinal case study examined the emergence of a wide range of oral language skills in a deaf child whose cochlear implant was activated at 20 months. The main purposes of this study were to determine "Hannah's" rate of spoken language development during her second to fourth year of implant experience and to estimate the efficiency of her progress by comparing her performance to that of typically developing children. Mother-child interactions were also examined to determine changes in Hannah's communication competence.

Changes in speech production in a child with a cochlear implant: acoustic and kinematic evidence.

A method is presented for examining change in motor patterns used to produce linguistic contrasts. In this case study, the method is applied to a child receiving new auditory input following cochlear implantation. This child experienced hearing loss at age 3 years and received a multichannel cochlear implant at age 7 years.

Technological Innovations and Intervention Practices for Children With Cochlear Implants.

This clinical forum has addressed many of the challenges associated with serving children who have cochlear implants. These include determining who may be a candidate for implantation; optimizing parent-child interactions for oral communication; developing comprehensive preschool programs; assessing and maximizing opportunities to communicate and learn in regular classrooms; making choices in communication modalities; providing effective intervention; and serving as a liaison for parents, school personnel, and medical professionals. In response to these challenges, the forum has provided the technical information needed to understand how a cochlear implant works, important research findings regarding choices in communication modalities, and ideas for assessing and serving children with implants.

Communication Intervention for Children With Cochlear Implants: Two Case Studies.

This article describes the intervention programs attended and progress made by 2 children who exhibited considerable differences in benefit from their cochlear implants. The children differed in many ways, including age at onset of deafness, preimplantation communications skills, age at implantation, the amount and types of intervention services received, and the rate at which they developed oral communication skills. Their intervention programs employed both analytical and synthetic auditory training and emphasized the development of speech production and language skills.

Introducing Young Children Who Are Deaf or Hard of Hearing to Spoken Language: Child'sVoice, an Oral School.

This article provides an overview of the workings of an oral school for children who are deaf or hard of hearing. The key features of the school include low student-teacher ratios, teachers who are trained as oral educators of deaf children, ongoing staff and parent education, specialized curricula, and a strong emphasis on listening and speaking throughout the day. Approximately 75% of the students at the school use cochlear implants; the remainder wear hearing aids.

Vocal Development in Young Children With Cochlear Implants: Profiles and Implications for Intervention.

Purpose: This article describes prelinguistic vocal development in 2 prelingually deaf children who received multichannel cochlear implants at 10 and 28 months of age, respectively.

Methods: Vocalizations were recorded in half-hour mother- child interactions before and after implantation and then classified into three levels of development: precanonical, canonical, and postcanonical.

Results: One child made rapid progress in vocal development after her implant was activated.

Challenges in Optimizing Oral Communication in Children With Cochlear Implants.

As the number of children with cochlear implants increases, more speech and hearing professionals will be called on to take leadership roles in developing specialized intervention and educational programs. Because of their graduate-level training in speech, language, and hearing disorders, speech-language pathologists and audiologists will increasingly find themselves viewed as "local experts" on cochlear implant issues. The articles in this forum support that role by addressing topics that are critical for serving children who have cochlear implants.