Deaf children need language, not (just) speech

Deaf and Hard of Hearing (DHH) children need to master at least one language (spoken or signed) to reach their full potential. Providing access to a natural sign language supports this goal. Despite evidence that natural sign languages are beneficial to DHH children, many researchers and practitioners advise families to focus exclusively on spoken language. We critique the Pediatrics article ‘Early Sign Language Exposure and Cochlear Implants’ (Geers et al., 2017) as an example of research that makes unsupported claims against the inclusion of natural sign languages. We refute claims that (1) there are harmful effects of sign language and (2) that listening and spoken language are necessary for optimal development of deaf children. While practical challenges remain (and are discussed) for providing a sign language-rich environment, research evidence suggests that such challenges are worth tackling in light of natural sign languages providing a host of benefits for DHH children – especially in the prevention and reduction of language deprivation.Accepted manuscrip

Why a diagnosis of neurofibromatosis calls for the attention of a deaf educator

This paper will seek to describe neurofibromatosis (NF), the scope of its impact, how NF relates to hearing loss, and why someone with a teacher of the deaf’s expertise may have information to offer the intervention team for a child diagnosed with NF

Early exposure to both sign and spoken language for children who are deaf or hard of hearing: Might it help spoken language development?

The literature on the benefits and deficits of bilingualism is reviewed with an emphasis on sign/spoken bilingualism and on the population of deaf or hard of hearing children. Since there are a limited number of reports on sign/spoken bilingualism for these children, a research plan is outlined for a large study whose results could have a significant impact on oral education policy and spoken language development in deaf or hard of hearing children

Development of audiovisual comprehension skills in prelingually deaf children with cochlear implants

Objective: The present study investigated the development of audiovisual comprehension skills in prelingually deaf children who received cochlear implants. Design: We analyzed results obtained with the Common Phrases (Robbins et al., 1995) test of sentence comprehension from 80 prelingually deaf children with cochlear implants who were enrolled in a longitudinal study, from pre-implantation to 5 years after implantation. Results: The results revealed that prelingually deaf children with cochlear implants performed better under audiovisual (AV) presentation compared with auditory-alone (A-alone) or visual-alone (V-alone) conditions. AV sentence comprehension skills were found to be strongly correlated with several clinical outcome measures of speech perception, speech intelligibility, and language. Finally, pre-implantation V-alone performance on the Common Phrases test was strongly correlated with 3-year postimplantation performance on clinical outcome measures of speech perception, speech intelligibility, and language skills. Conclusions: The results suggest that lipreading skills and AV speech perception reflect a common source of variance associated with the development of phonological processing skills that is shared among a wide range of speech and language outcome measures

Aging, Cognitive Decline and Hearing Loss: Effects of Auditory Rehabilitation and Training with Hearing Aids and Cochlear Implants on Cognitive Function and Depression among Older Adults

A growing interest in cognitive effects associated with speech and hearing processes is spreading throughout the scientific community essentially guided by evidence that central and peripheral hearing loss is associated with cognitive decline. For the present research, 125 participants older than 65 years of age (105 with hearing impairment and 20 with normal hearing) were enrolled, divided into 6 groups according to their degree of hearing loss and assessed to determine the effects of the treatment applied. Patients in our research program routinely undergo an extensive audiological and cognitive evaluation protocol providing results from the Digit Span test, Stroop color-word test, Montreal Cognitive Assessment and Geriatric Depression Scale, before and after rehabilitation. Data analysis was performed for a cross-sectional and longitudinal study of the outcomes for the different treatment groups. Each group demonstrated improvement after auditory rehabilitation or training on shortand long-term memory tasks, level of depression and cognitive status scores. Auditory rehabilitation by cochlear implants or hearing aids is effective also among older adults (median age of 74 years) with different degrees of hearing loss, and enables positive improvements in terms of social isolation, depression and cognitive performance

The Role of Multiple Articulatory Channels of Sign-Supported Speech Revealed by Visual Processing

Purpose The use of sign-supported speech (SSS) in the education of deaf students has been recently discussed in relation to its usefulness with deaf children using cochlear implants. To clarify the benefits of SSS for comprehension, 2 eye-tracking experiments aimed to detect the extent to which signs are actively processed in this mode of communication. Method Participants were 36 deaf adolescents, including cochlear implant users and native deaf signers. Experiment 1 attempted to shift observers' foveal attention to the linguistic source in SSS from which most information is extracted, lip movements or signs, by magnifying the face area, thus modifying lip movements perceptual accessibility (magnified condition), and by constraining the visual field to either the face or the sign through a moving window paradigm (gaze contingent condition). Experiment 2 aimed to explore the reliance on signs in SSS by occasionally producing a mismatch between sign and speech. Participants were required to concentrate upon the orally transmitted message. Results In Experiment 1, analyses revealed a greater number of fixations toward the signs and a reduction in accuracy in the gaze contingent condition across all participants. Fixations toward signs were also increased in the magnified condition. In Experiment 2, results indicated less accuracy in the mismatching condition across all participants. Participants looked more at the sign when it was inconsistent with speech. Conclusions All participants, even those with residual hearing, rely on signs when attending SSS, either peripherally or through overt attention, depending on the perceptual conditions.Unión Europea, Grant Agreement 31674

Intellectual autonomy, epistemic dependence and cognitive enhancement

Intellectual autonomy has long been identified as an epistemic virtue, one that has been championed influentially by (among others) Kant, Hume and Emerson. Manifesting intellectual autonomy, at least, in a virtuous way, does not require that we form our beliefs in cognitive isolation. Rather, as Roberts and Wood (Intellectual virtues: an essay in regulative epistemology, OUP Oxford, Oxford, pp. 259–260, 2007) note, intellectually virtuous autonomy involves reliance and outsourcing (e.g., on other individuals, technology, medicine, etc.) to an appropriate extent, while at the same time maintaining intellectual self-direction. In this essay, I want to investigate the ramifications for intellectual autonomy of a particular kind of epistemic dependence: cognitive enhancement. Cognitive enhancements (as opposed to therapeutic cognitive improvements) involve the use of technology and medicine to improve cognitive capacities in healthy individuals, through mechanisms ranging from smart drugs to brain-computer interfaces. With reference to case studies in bioethics, as well as the philosophy of mind and cognitive science, it is shown that epistemic dependence, in this extreme form, poses a prima facie threat to the retention of intellectual autonomy, specifically, by threatening to undermine our intellectual self-direction. My aim will be to show why certain kinds of cognitive enhancements are subject to this objection from self-direction, while others are not. Once this is established, we’ll see that even some extreme kinds of cognitive enhancement might be not merely compatible with, but constitutive of, virtuous intellectual autonomy

Verbal Learning and Memory After Cochlear Implantation in Postlingually Deaf Adults: Some New Findings with the CVLT-II

OBJECTIVES: Despite the importance of verbal learning and memory in speech and language processing, this domain of cognitive functioning has been virtually ignored in clinical studies of hearing loss and cochlear implants in both adults and children. In this article, we report the results of two studies that used a newly developed visually based version of the California Verbal Learning Test-Second Edition (CVLT-II), a well-known normed neuropsychological measure of verbal learning and memory. DESIGN: The first study established the validity and feasibility of a computer-controlled visual version of the CVLT-II, which eliminates the effects of audibility of spoken stimuli, in groups of young normal-hearing and older normal-hearing (ONH) adults. A second study was then carried out using the visual CVLT-II format with a group of older postlingually deaf experienced cochlear implant (ECI) users (N = 25) and a group of ONH controls (N = 25) who were matched to ECI users for age, socioeconomic status, and nonverbal IQ. In addition to the visual CVLT-II, subjects provided data on demographics, hearing history, nonverbal IQ, reading fluency, vocabulary, and short-term memory span for visually presented digits. ECI participants were also tested for speech recognition in quiet. RESULTS: The ECI and ONH groups did not differ on most measures of verbal learning and memory obtained with the visual CVLT-II, but deficits were identified in ECI participants that were related to recency recall, the buildup of proactive interference, and retrieval-induced forgetting. Within the ECI group, nonverbal fluid IQ, reading fluency, and resistance to the buildup of proactive interference from the CVLT-II consistently predicted better speech recognition outcomes. CONCLUSIONS: Results from this study suggest that several underlying foundational neurocognitive abilities are related to core speech perception outcomes after implantation in older adults. Implications of these findings for explaining individual differences and variability and predicting speech recognition outcomes after implantation are discussed

Speech intelligibility and prosody production in children with cochlear implants

Objectives—The purpose of the current study was to examine the relation between speech intelligibility and prosody production in children who use cochlear implants. Methods—The Beginner\u27s Intelligibility Test (BIT) and Prosodic Utterance Production (PUP) task were administered to 15 children who use cochlear implants and 10 children with normal hearing. Adult listeners with normal hearing judged the intelligibility of the words in the BIT sentences, identified the PUP sentences as one of four grammatical or emotional moods (i.e., declarative, interrogative, happy, or sad), and rated the PUP sentences according to how well they thought the child conveyed the designated mood. Results—Percent correct scores were higher for intelligibility than for prosody and higher for children with normal hearing than for children with cochlear implants. Declarative sentences were most readily identified and received the highest ratings by adult listeners; interrogative sentences were least readily identified and received the lowest ratings. Correlations between intelligibility and all mood identification and rating scores except declarative were not significant. Discussion—The findings suggest that the development of speech intelligibility progresses ahead of prosody in both children with cochlear implants and children with normal hearing; however, children with normal hearing still perform better than children with cochlear implants on measures of intelligibility and prosody even after accounting for hearing age. Problems with interrogative intonation may be related to more general restrictions on rising intonation, and th

Bilateral cochlear implantation or bimodal listening in the paediatric population : retrospective analysis of decisive criteria

Introduction: In children with bilateral severe to profound hearing loss, bilateral hearing can be achieved by either bimodal stimulation (CIHA) or bilateral cochlear implantation (BICI). The aim of this study was to analyse the audiologic test protocol that is currently applied to make decisions regarding the bilateral hearing modality in the paediatric population. Methods: Pre- and postoperative audiologic test results of 21 CIHA, 19 sequential BICI and 12 simultaneous BICI children were examined retrospectively. Results: Deciding between either simultaneous BICI or unilateral implantation was mainly based on the infant's preoperative Auditory Brainstem Response thresholds. Evolution from CIHA to sequential BICI was mainly based on the audiometric test results in the contralateral (hearing aid) ear after unilateral cochlear implantation. Preoperative audiometric thresholds in the hearing aid ear were significantly better in CIHA versus sequential BICI children (p < 0.001 and p = 0.001 in unaided and aided condition, respectively). Decisive values obtained in the hearing aid ear in favour of BICI were: An average hearing threshold measured at 0.5, 1, 2 and 4 kHz of at least 93 dB HL without, and at least 52 dB HL with hearing aid together with a 40% aided speech recognition score and a 70% aided score on the phoneme discrimination subtest of the Auditory Speech Sounds Evaluation test battery. Conclusions: Although pure tone audiometry offers no information about bimodal benefit, it remains the most obvious audiometric evaluation in the decision process on the mode of bilateral stimulation in the paediatric population. A theoretical test protocol for adequate evaluation of bimodal benefit in the paediatric population is proposed