Mothers' Speech to Hearing‐Impaired Infants and Children With Cochlear Implants

This study investigated the effects of age, hearing loss, and cochlear implantation on mothers' speech to infants and children. We recorded normal‐hearing (NH) mothers speaking to their children as they typically would do at home and speaking to an adult experimenter. Nine infants (10–37 months) were hearing‐impaired and had used a cochlear implant (CI) for 3 to 18 months. Eighteen NH infants and children were matched either by chronological age (10–37 months) or hearing experience (3–18 months) to the CI children. Prosodic characteristics such as fundamental frequency, utterance duration, and pause duration were measured across utterances in the speech samples. The results revealed that mothers use a typical infant‐directed speech style when speaking to hearing‐impaired children with CIs. The results also suggested that NH mothers speak with more similar vocal styles to NH children and hearing‐impaired children with CIs when matched by hearing experience rather than chronological age. Thus, mothers are sensitive to hearing experience and linguistic abilities of their NH children as well as hearing‐impaired children with CIs.     

Temporal Responsiveness in Mother–Child Dialogue: A Longitudinal Analysis of Children with Normal Hearing and Hearing Loss

Dialogue between conversational partners, including mothers and their children, is precisely timed. The predictability of this timing is important for establishing and maintaining interaction, communication, and learning. This longitudinal study examines changes in the response latency of utterances in dialogue between mothers and their normal hearing and hearing‐impaired children between 4 and 60 months of age. Mothers and their children showed parallel developmental trends, responding to each other more quickly at older ages. Beyond these age‐related group effects, significant dyadic effects were found in which individual children's latencies were related to those of their mothers, and vice versa. Developmental patterns did not significantly differ across hearing status groups, which may reflect the role of early identification and intervention in promoting positive developmental outcomes.     

Non word Repetition and Reading Skills in Children Who Are Deaf and Have Cochlear Implants

Reading skills in hearing children are closely related to their phonological processing skills, often measured using a nonword repetition task in which a child relies on abstract phonological representations in order to decompose, encode, rehearse in working memory and reproduce novel phonological patterns. In the present study of children who are deaf and have cochlear implants, we found that nonword repetition performance was significantly related to nonword reading, single word reading and sentence comprehension. Communication mode and nonverbal IQ were also found to be correlated with nonword repetition and reading skills. A measure of the children's lexical diversity, derived from an oral language sample, was found to be a mediating factor in the relationship between nonword repetition and reading skills. Taken together, the present findings suggest that the construction of robust phonological representations and phonological processing skills may be important contributors to the development of reading in children who are deaf and use cochlear implants.     

Individual Differences in Effectiveness of Cochlear Implants in Children Who Are Prelingually Deaf: New Process Measures of Performance

The efficacy of cochlear implants in children who are deaf has been firmly established in the literature. However, the effectiveness of cochlear implants varies widely and is influenced by demographic and experiential factors. Several key findings suggest new directions for research on central auditory factors that underlie the effectiveness of cochlear implants. First, enormous individual differences have been observed in both adults and children on a wide range of audiological outcome measures. Some patients show large increases in speech perception scores after implantation, whereas others display only modest gains on standardized tests. Second, age of implantation and length of deafness affect all outcome measures. Children implanted at younger ages do better than children implanted at older ages, and children who have been deaf for shorter periods do better than children who have been deaf for longer periods. Third, communication mode affects outcome measures. Children from "oral-only" environments do much better on standardized tests that assess phonological processing skills than children who use Total Communication. Fourth, at the present time there are no preimplant predictors of outcome performance in young children. The underlying perceptual, cognitive, and linguistic abilities and skills emerge after implantation and improve over time. Finally, there are no significant differences in audiological outcome measures among current implant devices or processing strategies. This finding suggests that the major source of variance in outcome measures lies in the neural and cognitive information processing operations that the user applies to the signal provided by the implant. Taken together, this overall pattern of results suggests that higher-level central processes such as perception, attention, learning, and memory may play important roles in explaining the large individual differences observed among users of cochlear implants. Investigations of the content and flow of information in the central nervous system and interactions between sensory input and stored knowledge may provide important new insights into the basis of individual differences. Knowledge about the underlying basis of individual differences may also help in developing new intervention strategies to improve the effectiveness of cochlear implants in children who show relatively poor development of oral/aural language skills.     

Effects of Phonotactic Probabilities on the Processing of Spoken Words and Nonwords by Adults with Cochlear Implants Who Were Postlingually Deafened

Probabilistic phonotactics refers to the frequency with which segments and sequences of segments occur in syllables and words. Knowledge of phonotactics has been shown to be an important source of information in recognizing spoken words in listeners with normal hearing. Two online tasks (an auditory same-different task and an auditory lexical decision task) were used to examine the use of phonotactic information by adults who were postlingually deafened who have received cochlear implants. The results of the experiments showed that cochlear implant patients with better word recognition abilities (as measured by the Northwestern University Auditory Test No. 6 (NU-6) produced patterns of results that were similar to the pattern of results obtained from listeners with normal hearing in Vitevitch and Luce (1999). This finding suggests that cochlear implant patients with better word recognition abilities use lexical and sublexical representations to process spoken words, much like listeners with normal hearing. In contrast, cochlear implant patients with poor word recognition abilities could not differentiate between stimuli varying in phonotactic probability and lexicality, suggesting that less distinct representations are used by these patients to process spoken words. The implications of these results for outcome assessments and clinical interventions are discussed.     

Age‐Related Changes in Prosodic Features of Maternal Speech to Prelingually Deaf Infants with Cochlear Implants

This study investigated prosodic and structural characteristics of infant‐directed speech to hearing‐impaired infants as they gain hearing experience with a cochlear implant over a 12‐month period of time. Mothers were recorded during a play interaction with their HI infants (N = 27, mean age 18.4 months) at 3, 6, and 12 months postimplantation. Two separate control groups of mothers with age‐matched normal‐hearing infants (NH‐AM) (N = 21, mean age 18.1 months) and hearing experience‐matched normal‐hearing infants (NH‐EM) (N = 24, mean age 3.1 months) were recorded at three testing sessions. Mothers produced less exaggerated pitch characteristics, a larger number of syllables per utterance, and faster speaking rate when interacting with NH‐AM as compared to HI infants. Mothers also produced more syllables and demonstrated a trend suggesting faster speaking rate in speech to NH‐EM relative to HI infants. Age‐related modifications included decreased pitch standard deviation and increased number of syllables in speech to NH‐AM infants and increased number of syllables in speech to HI and NH‐EM infants across the 12‐month period. These results suggest that mothers are sensitive to the hearing status of their infants and modify characteristics of infant‐directed speech over time.     

Development of Pre-Word-Learning Skills in Infants with Cochlear Implants

Families of infants who are congenitally deaf now have the option of cochlear implantation at a very young age. In order to assess the effectiveness of early cochlear implantation, however, new behavioral procedures are needed to measure speech perception and language skills during infancy. One important component of language development is word learning-a complex skill that involves learning arbitrary relations between words and their referents. A precursor to word learning is the ability to perceive and encode intersensory relations between co-occurring auditory and visual events. Recent studies in infants with normal hearing have shown that intersensory redundancies, such as temporal synchrony, can facilitate the ability to learn arbitrary pairings between speech sounds and objects (Gogate & Bahrick, 1998). To investigate the early stages of learning arbitrary pairings of sounds and objects after cochlear implantation, we used the Preferential Looking Paradigm (PLP) to assess infants' ability to associate speech sounds to objects that moved in temporal synchrony with the onset and offsets of the signals. Children with normal hearing ranging in age from 6, 9, 18, and 30 months served as controls and demonstrated the ability to learn arbitrary pairings between temporally synchronous speech sounds and dynamic visual events. Infants who received their cochlear implants (CIs) at earlier ages (7-15 months of age) performed similarly to the infants with normal hearing after about 2-6 months of CI experience. In contrast, infants who received their implants at later ages (16-25 months of age) did not demonstrate learning of the associations within the context of this experiment. Possible implications of these findings are discussed.     

Working Memory Spans as Predictors of Spoken Word Recognition and Receptive Vocabulary in Children with Cochlear Implants

The present study investigated whether individual differences in working memory could account for a significant proportion of the variance in the open-set word recognition and receptive vocabulary skills of prelingually deafened, pediatric cochlear implant recipients, after the contribution of known predictors was taken into account. The contributions of four measures of working memory were examined separately for children using oral communication (OC) (n = 32) and Total Communication (TC) (n = 29). Wechsler Intelligence Scale for Children-Third Edition (WISC) digit-spans, requiring immediate recall of auditory-only lists in both forwards and backwards directions were, collected. Two versions of a novel "memory span game" were also administered: One required memory for sequences of colored lights; the other assessed memory for colored lights presented in conjunction with auditory color-names. A contribution from working memory was observed only for the span tasks that incorporated an auditory processing component. These results suggest a relationship between working memory and the examined outcome measures that is specific to the auditory modality, partially linked to communication mode, and not related to individual differences in a general-purpose component of working memory.     

Perpetual Silence,Not Silence for Moments: Hearing Loss of Children as Perceived by Hearing Bedouin Mothers

The Negev Bedouin population in southern Israel, a minority undergoing great social change, has a higher incidence of hearing loss than that reported elsewhere but has hardly been studied. Caring for a child with hearing loss often engenders parental stress because of the many tasks involved. Difficulty in accessing information and services, the lack of public transportation nearby, and other aspects of the living conditions of Negev Bedouin parents present additional challenges. These difficulties are further compounded by the unique socio-demographic and cultural characteristics of this indigenous population. This article presents the parenting experience of 20 hearing Bedouin mothers of children with hearing loss, explored in a qualitative phenomenological study. The findings indicate that the mothers’ perceptions of the child’s hearing loss affect how they cope with the birth and rearing of the child, their view of the child, and their attitude toward medical interventions. These findings, which portray an experience that is unique in many ways, contribute to the understanding of how an underserved, indigenous, and traditional population responds to congenital hearing loss. The findings also reveal the importance of the terminology with which parents describe their child’s hearing loss and the unique meanings it may have. Such knowledge is of particular importance for culturally sensitive and effective provision of social services and therapeutic interventions.     

Therapy Outcome with Children in Foster Care: A Longitudinal Study

The present paper describes a naturalistic study of therapy with children in foster care. The goal was to attempt to begin to understand what happens to children in foster care while they are in therapy. The functioning of all children referred for therapy in a foster care agency was assessed as rated by different informants at different points in time over an 18-month period. These children present with low-level behavior problems but the level and type of problem they present with depends on the person rating the child and the child’s gender and age. Two thirds of the children improve and do so within the early stages of therapy. One third of the children do not improve. The distinguishing feature of this group appears to be the high level of aggressive behaviors reported at intake. Results suggest that improvement depends on the eye of the beholder. These findings are discussed and recommendations for therapeutic and systemic practice are made. The importance of using multiple informants when evaluating the treatment needs of children in care is pointed out as is the need to rethink therapeutic strategies with children that present with high levels of aggressive behavior at intake and show no improvement after the first 6 months of therapy.     

Parental Linguistic Input and Its Relation to Toddlers’ Visual Attention in Joint Object Play: A Comparison Between Children with Normal Hearing and Children With Hearing Loss

Parent–child interactions are multimodal, often involving coordinated exchanges of visual and auditory information between the two partners. The current work focuses on the effect of children's hearing loss on parent–child interactions when parents and their toddlers jointly played with a set of toy objects. We compared the linguistic input received by toddlers with hearing loss (HL) and their chronological age‐matched (CA) and hearing age‐matched (HA) normal‐hearing peers. Moreover, we used head‐mounted eye trackers to examine how different parental linguistic input affected children's visual attention on objects when parents either led or followed children's attention during joint object play. Overall, parents of children with HL provided comparable amount of linguistic input as parents of the two normal‐hearing groups. However, the types of linguistic input produced by parents of children with HL were similar to the CA group in some ways and similar to the HA group in other ways. Interestingly, the effects of different types of linguistic input on extending the attention of children with HL qualitatively resembled the patterns seen in the CA group, even though the effects were less pronounced in the HL group. We discuss the implications of these results for our understanding of the reciprocal, dynamic, and multi‐factored nature of parent–child interactions.     

Sexual Abuse by Men Who Work with Children

There is a dearth of knowledge about those who sexually abuse children while working in organizations. Here, we adopt a case study approach to examine this problem. We focus on eight adult males who had been imprisoned for abusing a total of 35 children while working in educational and voluntary settings. We provide a detailed account of abusers' characteristics, their strategies, how victims were selected, how trust was secured, and how victims' silence was ensured. Finally, we reflect on the extent to which our work might contribute toward the prevention of this form of abuse.     

Knowledge,Attitude and Practice of Child Sexual Abuse Prevention among Parents of Children with Hearing Loss: A Pilot Study in Beijing and Hebei Province,China

ABSTRACT

This study aimed to examine the knowledge, attitude, and practice (KAP) of child sexual abuse (CSA) prevention among parents of children with hearing loss. The study involved 127 pairs of parents with deaf and hard of hearing children from three special education schools in Beijing and Hebei province, China. The findings revealed that the parents lacked knowledge about CSA prevention, such as the character of perpetrators and child victims. Parents were supportive about potential CSA prevention education in schools. Most parents told children much about personal safety, but topics on CSA prevention were still insufficient. The study also found that education level was significantly associated with knowledge and attitude. Elder parents knew more and talked more about CSA prevention. Mothers and girls’ parents were more willing to communicate with children about CSA prevention. The conclusion of the study was that parents appeared to have gained a positive attitude, but poor knowledge and practice. Their knowledge and skills of effective communication should be strengthened to promote CSA prevention practice.     

A Prospective Study of Behavioural Disturbance in Children Who Subsequently Experience Parental Divorce

This study examines changes in children's behaviour as a function of parental divorce. As part of a large scale general population study on the effects of marital disharmony on children, 139 children from the general population were followed up from a previous study. These children and their mothers were interviewed first between 1979 and 1982 (time 1) and then followed up between 1984 and 1986 (time 2). Between the time 1 interview and the time 2 interview, 16 children's parents had separated or divorced. This paper deals with the mothers' report of changes in the behaviour of these children between time 1 and time 2 as a function of their parents' divorce, and compares this with changes in children's behaviour whose parents live in disharmonious (N = 40) or harmonious homes (N = 50). Children's reports of their own behaviour at time 2 are also presented. The data show that children in disharmonious homes and children whose parents subsequently divorce show higher levels of disturbance than children in harmonious homes. Children whose parents subsequently divorce show their disturbance prior to the divorce. Children's coping strategies in response to divorce were also investigated and and an association was found between children's behavioural problems and (a) self-blame and (b) not having friends whose parents had divorced.     

Employment Behaviors of Mothers Who have a Child with Asthma

The effects of having a child with asthma on the employment status and the continuity of full-time employment of mothers were investigated using data from the Medical Expenditure Panel Survey. Mothers who had a child with asthma were less likely to be employed full-time or part-time, and if single, they were less likely to retain their full-time jobs than other mothers. The effects of having a child with asthma depended on the marital status of the mother and the well-being of the child. Employment behaviors of single mothers were affected more than those of married mothers. The bed days of children reduced the prevalence and continuation of full-time employment for single and married mothers.     

A Clinical Sample of Women Who Have Sexually Abused Children

The research described is a study of a clinical sample of 72 women who allegedly sexually abused 332 children. The Sample is examined from a variety of perspectives, including whether the abuse was intrafamilial (n = 33), extrafamilial (n = 18), or both (n = 21); and whether the abuse involved multiple intrafamilial offenders (n = 33), a solo intrafamilial offender (n = 17), multiple extrafamilial offenders (n = 16), or solo extrafamilial offenders (n = 6). Social situational factors and individual deficits [mental illness (n = 23), mental retardation (n = 16), substance abuse (n = 37), and other maltreatment of their children (n = 61)] that might lead women to sexually abuse children are examined. Case outcomes, including the number of confessions (n = 49), criminal prosecution (n = 3), and protection of victims (n = 44) are described.     

Maternal Work Absence: A Longitudinal Study of Language Impairment and Behavior Problems in Preschool Children

Combining work and family responsibilities is challenging when children have special needs, and mothers commonly make employment‐related adjustments. In this study, the authors examined associations between maternal work absence and child language impairment and behavior problems in preschool children. Questionnaire data at child age 3 years from 33,778 mothers participating in the prospective population‐based Norwegian Mother and Child Cohort Study were linked to national register data on employment and long‐term physician‐certified sick leave at child age 3–5 years. Mothers who reported having a child with language impairment had a consistently higher risk of not being employed and were at increased risk of taking long‐term sick leave at child age 5 years. Co‐occurring problems were associated with excess risk. Language impairments in preschool children, in particular when they are co‐occurring with behavior problems, are likely to have a range of negative short‐ and long‐term consequences for the financial and overall health and well‐being of mothers and their families.     

Use of Partial Stimulus Information by Cochlear Implant Users and Listeners with Normal Hearing in Identifying Spoken Words: Some Preliminary Analyses

An error analysis of the word recognition responses of cochlear implant users and listeners with normal hearing was conducted to determine the types of partial information used by these two populations when they identified spoken words under auditory-alone and audiovisual conditions. The results revealed that the two groups used different types of partial information in identifying spoken words under auditory-alone or audiovisual presentation. Different types of partial information were also used in identifying words with different lexical properties. In our study, however, there were no significant interactions with hearing status, indicating that cochlear implant users and listeners with normal hearing identify spoken words in a similar manner. The information available to users with cochlear implants preserves much of the partial information necessary for accurate spoken word recognition.     

A Support Group for Families who have Children in Care: an Evaluative Case Study

This article evaluates an attempt to establish a support group for parents and relatives whose children are in care in one health board in Ireland. It uses a qualitative methodology, drawing on a group evaluation session, supplemented by individual interviews with the members of that group. The paper shows that it was successful in so far as it provided members with a forum where they felt accepted, where their rights as parents were validated, their self-esteem enhanced and informal access provided to senior social workers. Finally, the paper suggests ways in which the therapeutic potential of such groups could be enhanced and more needy parents attracted into them.