Identification of effective strategies to promote language in deaf children with cochlear implants.

摘要

A great deal of evidence suggests that parental communication and involvement are essential for the development of language in young children. However, hearing parents of deaf children face unique challenges in providing appropriate stimulation and language input to their deaf children. To date, few studies have determined which types of input are best. This study utilized data collected from the largest, youngest, nationally representative sample of deaf children receiving cochlear implants. The purpose of this study was to identify the facilitative language techniques that are most effective in facilitating receptive and expressive language development in young deaf children. Ninety-three deaf children, ages 2 years and under were enrolled at six implant centers. Deaf children were assessed prior to implantation and then followed for three years post-implantation. At each assessment, parent-child interactions were videotaped in an unstructured Free Play and structured Art Gallery task. All parent and child speech, vocalizations, and sign language were transcribed from the 10 minute videotaped parent-child interactions and coded using the Parenting Strategies for Communication coding system. Results revealed that the most frequently used lower-level strategies used by parents were directives, comments, and close-ended questions. The most frequently used higher-level strategies were parallel talk, open-ended questions, and recast. In addition, the Art Gallery task facilitated more parent utterances and longer mean length of utterances compared to Free Play, but the frequency of facilitative language techniques was not different. Using bivariate latent difference score modeling, higher-level strategies predicted growth in expressive language scores across three years post-implantation. Further, higher-level strategies had a delayed effect on receptive language, with techniques used at 24 months post-implantation predicting growth in receptive language at 36 months post-implantation. These results suggested that parent's play an active role in facilitating their child's language development. Interventions for parents should be developed using a coaching model, where parents receive hands-on training and practice using these effective facilitative language techniques. Future studies should evaluate the effectiveness of this intervention, as well as the effectives of these language techniques in children implanted after 2 years of age.