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Language Performance of Adolescents with Cochlear Implants: Strengths,
Weaknesses, and Contributing Factors
Susan Nittrouer, Joseph Antonelli, Joanna Lowenstein, & Popy Shell
University of Florida
R01 DC006237 and R01 DC015992 from the National Institute on Deafness and Other Communication Disorders
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Can they survive in mainstream education with so little support? Really?
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Language Performance onKindergarten Entry
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More Language to Learn in Elementary School
Phonological Sensitivity
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igneous
eskers
varvesUptick inAcademic Demands
eclogite
amphibolitekames
drumlins
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Amount of Intervention
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Where do we stand now – at the end of middle school?
NH CI
Means (SDs) Means (SDs)
Number 45 47
SES 35 (14) 33 (11)
NVIQ 106 (13) 102 (14)
Spatial Working Memory 87% (10%) 85% (10%)
Age 1st CI 14 month = median
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Where do we stand now – at the end of middle school?
Lexicosyntactic Skills
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Where do we stand now – at the end of middle school?
Phonological Sensitivity
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Where do we stand now – at the end of middle school?
Productive Syntax
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Where do we stand now – at the end of middle school?
Narrative Skills
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Where do we stand now – at the end of middle school?
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The Bottom Line
There’s a lot of language development that happens during the school years.
Children with cochlear implants show delays learning that language.
Those delays are largest for phonologically based language functions, complex syntax, and writing.
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So what’s a clinician supposed to do?
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Exp Vocab Sent Comp Gram Judg FCC Pig Latin BackWords
SES .439 .311 .385 .254 .348 .307
NVIQ .472 .557 .548 .492 .522 .610
Age 1st CI .019 -.015 .056 .007 -.152 .000
Effects of Demographics(CI only)
bolded = p < .01 Pearson product-moment r
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48 mo Exp Vocab Sent Comp Gram Judg FCC Pig Latin BackWords
Exp Vocab .634 .439 .562 .526 .424 .428
PLS AuditoryComprehend
.335 .392 .429 .397 .355 .354
Speech Intelligibility .557 .504 .577 .556 .573 .521
Effects of Skills at 48 months
bolded = p < .01 Pearson product-moment r
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During the School Years
• Provide ample opportunity to discover phonological structure
• Emphasize reading instruction
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What can we do as a profession?Advocate for adequate and appropriate intervention
Expand training programs for professionals serving school-age children with hearing loss
Translational research on effective interventions
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The Summary