Narrative skills and language comprehension in preschool children with cochlear implants: A comparison with children with Developmental Language Disorder or typical development.

INTRODUCTION: The narrative skills of children with cochlear implants (CIs) are fragile, but the factors at play and whether these difficulties could be similar to those detected in language impairment are not clear. The present study aims to assess, at the microstructural level, narrative skills, comparing children with CIs with children with Developmental Language Disorder (DLD) or Typical Development (TD). Furthermore, the relationship between verbal (lexical and morphosyntactic) comprehension and narrative skills across groups is investigated. METHODS: The narratives of 19 children with CIs (Mage = 62.42 months, SD = 6.83), 13 children with DLD (Mage = 65.38 months, SD = 4.27), and 18 preschool children with TD (Mage = 63.67 months, SD = 4.31) were assessed in a standardized task. Articles, prepositions, pronouns, gender and number agreement, accuracy in the use of verbs, and number of arguments in each sentence were analysed. Lexical and morphosyntactic comprehension were also assessed. Performance was compared across groups using ANOVAs or Kruskal-Wallis tests. The role of lexical and morphosyntactic comprehension in predicting each morphological and syntactic element in the narrative task was examined using linear regressions. RESULTS: Data analysis showed that both children with CIs and DLD had fragilities in narration, both in the morphological and syntactic components. Although some differences between children with CIs and those with DLD emerged in descriptive analyses, these were not statistically significant. Regressions showed that morphosyntactic comprehension predicted the number of pronouns produced only in the TD group. CONCLUSIONS: The scarce differences between CI and DLD groups and the absence of an effect of morphosyntactic comprehension on pronoun production may be due to their low production of these elements in the narrative task and/or to a difficulty in managing pronouns in an expressive task regardless of their ability to comprehend them. Potential implications of these results are discussed.

Do Acoustic Environment Characteristics Affect the Lexical Development of Children With Cochlear Implants? A Longitudinal Study Before and After Cochlear Implant Activation.

Purpose This study investigates the acoustic environment of children with cochlear implants (CIs) and the relationship between exposure to speech, in noise and in quiet, and the children's lexical production up to 1 year after CI activation, while controlling for the effect of early individual differences in receptive vocabulary growth. Method Eighteen children with CIs were observed at 3, 6, and 12 months after CI activation. Children's spontaneous word production during interaction with their mothers (types and tokens) and their expressive and receptive vocabulary size were considered. The characteristics of the acoustic environments in terms of acoustic scenes (speech in noise or in quiet, quiet, noise, music, and other) and of loudness ranges were assessed using data logging of the children's devices. Results Data analysis showed that both the number of tokens and the number of types produced 1 year after CI activation were affected by the children's exposure to speech in quiet with a loudness range between 40 and 69 dB. Expressive vocabulary size and types were affected by the receptive vocabulary knowledge that the children achieved over the first 3 months after CI activation. Conclusions Our data support the role of speech environment and individual differences in early comprehension on lexical production. The importance of exposure to speech with particular characteristics for the lexical development of children with CIs and the implications for clinical practice are discussed.

Preverbal Production and Early Lexical Development in Children With Cochlear Implants: A Longitudinal Study Following Pre-implanted Children Until 12 Months After Cochlear Implant Activation.

Studies have shown that children vary in the trajectories of their language development after cochlear implant (CI) activation. The aim of the present study is to assess the preverbal and lexical development of a group of 20 Italian-speaking children observed longitudinally before CI activation and at three, 6 and 12 months after CI surgery (mean age at the first session: 17.5 months; SD: 8.3; and range: 10-35). The group of children with CIs (G-CI) was compared with two groups of normally-hearing (NH) children, one age-matched (G-NHA; mean age at the first session: 17.4 months; SD: 8.0; and range: 10-34) and one language-matched (G-NHL; n = 20; mean age at the first session: 11.2 months; SD: 0.4; and range: 11-12). The spontaneous interactions between children and their mothers during free-play were transcribed. Preverbal babbling production and first words were considered for each child. Data analysis showed significant differences in babbling and word production between groups, with a lower production of words in children with CIs compared to the G-NHA group and a higher production of babbling compared to the G-NHL children. Word production 1 year after activation was significantly lower for the children with CIs than for language-matched children only when maternal education was controlled for. Furthermore, latent class growth analysis showed that children with CIs belonged mainly to classes that exhibited a low level of initial production but also progressive increases over time. Babbling production had a statistically significant effect on lexical growth but not on class membership, and only for groups showing slower and constant increases. Results highlight the importance of preverbal vocal patterns for later lexical development and may support families and speech therapists in the early identification of risk and protective factors for language delay in children with CIs.

Ser mãe, ser pai: desafios na contemporaneidade / To be a mother, to be a father: the challenges in the contemporary world

Observa-se que no contexto cultural da atualidade, com a quebra dos valores rígidos, estáticos e a abertura para as múltiplas possibilidades de subjetivação, de modos de existência, o vir a ser mãe e pai precisa ser criado, inventado a cada nova experiência. Este artigo se propõe a discutir essas questões, a partir de um recorte psicanalítico – especialmente o conceito de Preocupação Materna Primária, de Winnicott – bem como das contribuições de Gilles Lipovetsky e Joel Birman, teóricos que estudam o mundo contemporâneo.(AU)

It is observed that in the cultural context of today, with the breaking of rigid, static values and the openness to the multiple possibilities of subjectivation, of modes of existence, becoming a mother and father must be created, invented with each new experience. This article proposes to discuss these issues from a psychoanalytic perspective – especially Winnicott’s concept of Primary Maternal Concern – as well as the contributions of Gilles Lipovetsky and Joel Birman, theorists who study the contemporary world.(AU)

Escutando famílias na rede pública: uma experiência de supervisão institucional com a equipe do PAIF - Programa de Atenção Integral à Família dos CRAS 1, Vinhedo/SP / Listening family in public assistance network social: an institutional experience of supervising the team of PAIF – Integral Family Care Program of the CRAS, Vinhedo/SP / Escuchando familias em la red pública: una experiencia de supervisión institucional con el equipo de PAIF – Programa de Atención Integral a la Familia de los CRAS, Vinhedo/SP

Neste artigo será apresentado o caminho percorrido por um trabalho de supervisão institucional psicanalítica à equipe técnica do Programa de Atenção Integral à Família dos CRAS Vinhedo/SP - PAIF, ressaltando como se deu o início dos trabalhos, a demanda inicial apresentada pelo serviço à psicanalista, como foi se constituindo o lugar dessa supervisão, enfim, os impasses, os progressos conseguidos e as possibilidades que se descortinaram. Veremos como o acolhimento de uma demanda inicial, ainda que equivocada, apresentada pela instituição, permitiu abrir um fértil campo de trabalho. O relato da experiência e a interlocução com autores da psicanálise compõem a argumentação, que pretentede propor um entendimento sobre o que pode ser considerado uma ação analítica no campo institucional. Atento à reconhecida importância de um espaço de escuta para o profissional que lida com situações de vulnerabilidade, esse trabalho oferece a oportunidade de se vislumbrar possibilidades de intervenção ainda que em ambientes aparentemente inóspitos.(AU)

This paper will present the path traveled by a psychoanalytical institutional supervision work to the technical staff of the PAIF - Integral Family Care Program of the CRAS Vinhedo/SP, highlighting as it was the beginning of the work, the initial demand made by the service to the psychoanalyst, how was been establishing the place of these supervision, at last, the impasses, progresses obtained and possibilities that was revealed. We will see how the welcome of that initial demand - though misguided - given by the institution, allowed to open a fertile field of work. The account of the experience and communication with authors of psychoanalysis make the argument, that intend propose a understanding of what can be considered an analytical action on the institutional camp. Aware of the perceived importance of a listening space for professionals dealing with vulnerability situations, this work offers the opportunity to glimpse possibilities of intervention even in seemingly inhospitable environments.(AU)

En éste artículo presentamos el camino recorrido en un trabajo de supervisión institucional psicoanalítica con el equipo técnico de PAIF -Programa de Atención Integral a la Familia de los CRAS Vinhedo/SP, resaltando como se dio desde el comienzo del trabajo una demanda inicial para incluir a la psicoanalista, y como fue se construyendo el lugar de esa supervisión; con dificultades y progresos conseguidos y con las posibilidades que surgieron. Veremos como al recibir la demanda inicial-aunque equivocada- solicitada por la institución, permitió abrir un campo fértil de trabajo. Se relata la experiencia y el diálogo establecido con autores psicoanalíticos que estructuran la argumentación teórica, que pretende proponer la comprensión de lo que puede ser considerada una acción analítica en el campo institucional. Consciente de la conocida importancia de un espacio de escucha para el profesional que tratan con situaciones de vulnerabilidad, este trabajo ofrece la oportunidad de vislumbrar las posibilidades de intervención inclusive en ambientes aparentemente inhóspitos.(AU)

Escutando famílias na rede pública: uma experiência de supervisão institucional com a equipe do PAIF - Programa de Atenção Integral à Família dos CRAS 1, Vinhedo/SP / Listening family in public assistance network social: an institutional experience of supervising the team of PAIF - Integral Family Care Program of the CRAS, Vinhedo/SP / Escuchando familias em la red pública: una experiencia de supervisión institucional con el equipo de PAIF - Programa de Atención Integral a la Familia de los CRAS, Vinhedo/SP

Neste artigo será apresentado o caminho percorrido por um trabalho de supervisão institucional psicanalítica à equipe técnica do Programa de Atenção Integral à Família dos CRAS Vinhedo/SP - PAIF, ressaltando como se deu o início dos trabalhos, a demanda inicial apresentada pelo serviço à psicanalista, como foi se constituindo o lugar dessa supervisão, enfim, os impasses, os progressos conseguidos e as possibilidades que se descortinaram. Veremos como o acolhimento de uma demanda inicial, ainda que equivocada, apresentada pela instituição, permitiu abrir um fértil campo de trabalho. O relato da experiência e a interlocução com autores da psicanálise compõem a argumentação, que pretentede propor um entendimento sobre o que pode ser considerado uma ação analítica no campo institucional. Atento à reconhecida importância de um espaço de escuta para o profissional que lida com situações de vulnerabilidade, esse trabalho oferece a oportunidade de se vislumbrar possibilidades de intervenção ainda que em ambientes aparentemente inóspitos.

This paper will present the path traveled by a psychoanalytical institutional supervision work to the technical staff of the PAIF - Integral Family Care Program of the CRAS Vinhedo/SP, highlighting as it was the beginning of the work, the initial demand made by the service to the psychoanalyst, how was been establishing the place of these supervision, at last, the impasses, progresses obtained and possibilities that was revealed. We will see how the welcome of that initial demand - though misguided - given by the institution, allowed to open a fertile field of work. The account of the experience and communication with authors of psychoanalysis make the argument, that intend propose a understanding of what can be considered an analytical action on the institutional camp. Aware of the perceived importance of a listening space for professionals dealing with vulnerability situations, this work offers the opportunity to glimpse possibilities of intervention even in seemingly inhospitable environments.

En éste artículo presentamos el camino recorrido en un trabajo de supervisión institucional psicoanalítica con el equipo técnico de PAIF -Programa de Atención Integral a la Familia de los CRAS Vinhedo/SP, resaltando como se dio desde el comienzo del trabajo una demanda inicial para incluir a la psicoanalista, y como fue se construyendo el lugar de esa supervisión; con dificultades y progresos conseguidos y con las posibilidades que surgieron. Veremos como al recibir la demanda inicial-aunque equivocada- solicitada por la institución, permitió abrir un campo fértil de trabajo. Se relata la experiencia y el diálogo establecido con autores psicoanalíticos que estructuran la argumentación teórica, que pretende proponer la comprensión de lo que puede ser considerada una acción analítica en el campo institucional. Consciente de la conocida importancia de un espacio de escucha para el profesional que tratan con situaciones de vulnerabilidad, este trabajo ofrece la oportunidad de vislumbrar las posibilidades de intervención inclusive en ambientes aparentemente inhóspitos.