Sign Movements Predict Consonant Acquisition in Young Children with Cochlear Implants

1. Sign Movements Predict Consonant Acquisition in Young Children with Cochlear Implants ASHA 2007 Boston, Massachusetts Brenda Seal, Ph.D. Debra Nussbaum, M.S. Kate Belzner, Ph.D/Au.D Student Susanne Scott, M.S. Lincoln Gray, Ph.D. Bettie Waddy-Smith, M.A.

2. Research Question:What changes occur in sign and spoken language acquisition following implantation?

3. English Consonants American Signs Welcome: w ε l k ɚ m Welcome: θΒRΒL)(

4. At 13 months old, 1 month post-implant 11 different sign movements 7 different handshapes 4 different locations 1 consonant

5. 17 months old, 4 months post implant 2 new sign movements (sum = 13) 1 new handshape (sum = 8) 1 new location (sum = 5) 3 new consonants (sum = 4) At 21 months old, 8 months post implant 3 new consonants (sum = 7) voiceless bilabial plosive /p/ voiceless velar plosive /k/ voiceless labiodental fricative /f/

6. At 24 months old, 11 months post implant 5 new sign movements (sum = 18) 3 new handshapes (sum = 11) 2 new locations (sum = 7) 3 new consonants (sum = 10)

12. Answering the research questions: • What changes occur in children’s sign and spoken language acquisition post implantation? • Are the changes predictable? • Across ages? • Across children with secondary disabilities? • How can these findings be used for programming?

13. About the Deaf Community Perspective • There is not one unified deaf community perspective on cochlear implants • Attitudes towards cochlear implants are changing • Culturally deaf families are beginning to consider implantation for their young children

14. Cochlear Implants and Sign Language: Putting It All Together April 2002

15. CIEC website

16. KidsWorld Deaf Net • Educational Settings • The Deaf Community Perspective • Communication • Methodology • Sign Language Use • Fitting the Speech • Processor • Training the Ear to Listen • Resources • What is a Cochlear Implant? • Cochlear Implant Candidacy • Factors Influencing • Performance • The Decision-Making Process • Considerations in the • Implantation Process • What About Insurance? • Surgical Considerations Available in Spanish

17. Cochlear Implants and Children: Considerations for Implantation and Educational Planning

18. National Training Workshops Spoken Language and Sign: Optimizing Learning for Children with Cochlear Implants

19. What we are learning Spoken Language and Sign…It does not have to be a competition!

20. However… For spoken language to develop: • Opportunities must be available to develop listening and speaking skills • There must be times when sign is not utilized • Spoken language must be valued and utilized in the child’s daily environment

21. The Big Picture We want children to be the most effective language users and communicators possible…. In any way possible! As early as possible !

22. Planning for diverse children

23. And each child with an implant will vary in their ability to “listen to learn” The path of “learning to listen” may vary for each child and

24. Fully Visual Communicator Mostly Visual Communicator Mostly Auditory Communicator Fully Auditory Communicator V VA Av A Receptive Communication Continuum

25. Receptive Communication • VAccesses communication visually via ASL/Signs or visual clarifiers • VAAccesses most information visually via ASL/Signs or visual clarifiers; obtains some benefit from auditory information • VAEqually accesses information via ASL/Signs or Spoken English • AvAccesses most information through spoken English, sometimes needs support via signs or visual clarifiers • AAccesses all information through Spoken English

26. Fully Sign Communicator Mostly Sign Communicator Mostly Oral Communicator Fully Oral Communicator S SO Os O Expressive Communication Continuum Continuum concept: Bettie Waddy-Smith

27. Expressive Communication • SUses Signs/ASL Only • SoPrimarily uses Signs/ASL; uses some oral communication • SOEqually able to use sign and oral communication • Os Primarily uses oral communication; uses signs for clarification • O Uses oral communication only

28. Develop an “Individualized Language Plan” To guide: • Language use • Placement • Child and Family Supports

29. Varied Roles of Sign Language • As a transition to oral language • As an ongoing clarifier of spoken English. • Bilingual development of ASL and Spoken English

30. LW • Age 4:11 years • Adopted at 2:5 years • Received CI at age: 2:9 years • Consistent use of both ASL and Spoken English in the home (mom is interpreter) • Consistent user of CI • Developing equal use of both ASL and English

31. Fully Visual Communicator Mostly Visual Communicator Mostly Auditory Communicator Fully Auditory Communicator V VA Av A LW Receptive Continuum Expressive Continuum Fully Sign Communicator Mostly Sign Communicator Mostly Oral Communicator Fully Oral Communicator S SO Os O

32. JC: Age 8.3 • Cochlear implant activation at: 3.1 years; not all electrodes could be inserted • Problems with getting a good map and keeping coil in place • Spanish used in the home • Family very interested in having Jason become an “auditory communicator • Consistently aware of Ling 6 sounds • Demonstrates awareness of single words and familiar sentences in a closed set; does not generalize spoken language skills outside of therapy sessions • Additional learning disabilities • Language development has been slow in both ASL and Spoken English • Difficulty in spontaneous and imitative production of new words and phrases

33. Fully Visual Communicator Mostly Visual Communicator Mostly Auditory Communicator Fully Auditory Communicator V VA Av A JC Receptive Continuum Expressive Continuum Fully Sign Communicator Mostly Sign Communicator Mostly Oral Communicator Fully Oral Communicator S SO Os O

34. Programs and Services at Kendall Demonstration Elementary School

35. M&Ms of Language Use Meeting each child at their auditory functioning level Modifying the “challenge factors” M onitoring use of sign language Making links between sign and spoken language M odeling spoken language

36. Your take away message • The demographics of children with cochlear implants varies widely • Spoken language and sign language outcomes vary for each child with a cochlear implant • Early use of sign language can support the acquisition of spoken language development • Continued research is important to support and validate the use of sign language with implanted children

37. Thank you to: • James Madison University and Gallaudet University’s Cochlear Implant Education Center for funding the graduate students who worked on this project: English King, Kelly Clingempeel Skubicz, Christi Hess, and Kate Belzner • The University of Virginia Cochlear Implant Center (Lori Bobsin) for referrals • The families and children involved in our project.

38. For more information contact: Debra.Nussbaum@gallaudet.edu