290 likes | 370 Views
Advances in Deafness Management Second Language Learning in Cochlear Implant Users October 9, 2005. Ripley K. WONG Speech Therapist In-charge Queen Mary Hospital Hong Kong. Hong Kong Scenario. Multilingual society Two formal languages: English & Chinese Return of sovereignty to PRC in 1997
E N D
Advances in Deafness ManagementSecond Language Learning in Cochlear Implant UsersOctober 9, 2005 Ripley K. WONG Speech Therapist In-charge Queen Mary Hospital Hong Kong
Hong Kong Scenario • Multilingual society • Two formal languages: English & Chinese • Return of sovereignty to PRC in 1997 • Immigrants from Mainland China • Maids needs for learning different languages
Language Development in HI Children • HI children develop language at slower rate (Davis et al, 1986) • Profoundly HI children develop language at half the rate of normal hearing children (Carney & Moeller 1998) • Increasing gap between language age and chronological age (Miyamoto et al, 1997)
Language Development in HI Children with CI • Language delay compared to NH peers, but rate of language development similar (Miyamoto et al, 1997; Vermeulen et al, 1999) • Rate of language development exceeded that of unimplanted HI children (Svirsky et al, 2000) • Different rate of development for different language skills (Ertmer et al, 2003, Young & Killen, 2002)
Second Language Learning in Hearing Impaired Children • Interference between languages • Reduced exposure to phonemic patterns / sound systems of spoken languages • Difficulty in picking up different phonemic patterns of different languages • Lack of natural ambient language input • Language delay resulting from hearing impairment
Bilingual CI Users • Age-appropriate language skills in primary language and competent in second spoken language (Waltzman et al, 2003) • CI users can achieve oral proficiency in more than one language (Robbins et al, 2004) • A CI user acquired Cantonese, Mandarin and English to a degree comparable to NH peers (Francis & Ho, 2003)
Case 1 • KC • 10 years old • Fitted with bilateral HA at 2;02 y.o. • No spoken language before implantation • CI done at 2 years 10 months (Clarion, S-Series) • Moved to an English-speaking country after implantation • 1st language: English
Case 1 • Returned to HK in 2003 (8;03) • studying in international school • Had Mandarin class in school • Started ST training on Cantonese in February 2004, aged 8;07 (totally attended 15 sessions from 2/04 to 12/04) • Re-started ST training in 4/05 (attended 5 sessions from 4/05 to 9/05)
Case 1: Language Assessment (English) • Peabody Picture Vocabulary Test (PPVT) • At high end of normal range • Clinical Evaluation of Language Fundamentals (CELF) • Receptive language: WNL • Expressive language: above average • 85-115: WNL, average of NH children: 100
Case 1: Language Assessment (Cantonese) • Cantonese Receptive Vocabulary Test (CRVT) • At the beginning of treatment: <1;10 (score:22) • One year after treatment: 2;06 (score: 30) • Raynell Developmental Language Scales (RDLS) • After one year of treatment: • VC: 2;01 • VE: 1;09
Case 1: Conclusion • Slow in acquiring 2nd language (Cantonese) • No interference with 1st language (English) development • Factors leading to slow acquisition: • Environmental factor: school, family • Interference from Mandarin • Personality factor
Case 2 • YC • 12 years 2 months old • Fitted with bilateral HA at 2;06 • Lived in Mainland China and spoke Mandarin before implantation • Studied in school for the deaf with total communication in Mainland • CI done at 6 years 10 months and 7 years 6 months (bilateral implantation, MedEl combi 40+ ) • Moved to HK in early 2001 (7;07)
Case 2 • Started ST training in Cantonese since February 2001 (7;08) • Enrolled in normal KG and primary school • Average academic performance • Uses mainly Cantonese to communicate
Case 2: Language Assessment (Mandarin) • Informal observation (pre-implant, CA: 6;09) • Short sentences (mainly 3-4 elements), no complex/compound sentences • Vocabulary: inadequate in view of his CA • Different speech acts noted (asking questions, making clarification, greetings, labelling, etc) • Not able to understand abstract concept e.g. conditional sentences
Case 2: Language Assessment (Cantonese) • RDLS • Delay in both verbal comprehension and verbal expression • Delay in verbal comprehension > verbal expression
Case 2: Speech Perception Assessment (Cantonese) • Paediatric Speech Perception Test • Vowel identification: 85% • Consonant identification: 65% • Tone identification: 64% • Sentence recognition: 80% • Connected speech comprehension: 70% • Performance comparable to same aged peers with Cantonese as 1st language
Case 2: Conclusion • Delayed development in 2nd language (Cantonese) acquisition • Possible explanation for the delay • Age at implantation • Delay in 1st language development • Constant gap between CA and speech perception ability but increasing gap with language age
Case 2: Conclusion • Speech Perception ability comparable to other implantees with Cantonese as 1st language • Development in 1st language slow down because of complete switch from 1st language to 2nd language
Case 3 • KK • 7 years 4 months old • Fitted with bilateral HA at 2;04 • No verbal language before implantation • CI at 3;04 (MedEl Combi 40+) • Lived in Mainland China • Studied in normal KG in Mainland • Speaks Mandarin
Case 3 • 1 year post-implant assessment (1st language, Mandarin) • RDLS (based on Cantonese Version): • CA:4;04 • VC: 2;10 • VE: 2;05 • Informal observation: • Speaking mainly 2-3 element sentences • Developed various word classes: verbs, nouns, adjectives • Rate of development exceeds increase in age
Case 3 • Had two months training in Cantonese (July to August 2004, age:6;04, 3 years post implant) • Showed significant improvement in vocabulary learning by CRVT: • Before treatment: raw score-3; AE-<1;10 • After treatment: raw score-27; AE-2;02 • Rate of acquisition exceeded age increase • Above-average academic achievement in 1st language • Treatment suspended because of family problem
Conclusion • CI users can acquire 2nd spoken language • Able to perceive the phonemic patterns of 2nd language • Functional use of the 2nd language • Delay in 2nd language development • 1st language development continues as long as it was continuously used in daily life
Conclusion • Possible factors affecting 2nd language acquisition • Age at implantation • Language ability in 1st language • Environmental stimulation for 2nd language • Language similarity, especially phonemic patterns