[Assessing language development in children with cochlear implants using the parental questionnaire FRAKIS]. / Der Einsatz des Elternfragebogens FRAKIS zur Erfassung des Sprachstandes bei Kindern mit Cochleaimplantat.

BACKGROUND: The aim of this study was to examine if the parental questionnaire FRAKIS (German CDI questionnaire on early language development) is a valid instrument for assessing linguistic progress in children with cochlear implants (CI). Descriptive statistics on the course of language acquisition in children with CI will also be presented. MATERIALS AND METHODS: Participants were 140 children with CI and language levels were assessed cross-sectionally with the parental questionnaire FRAKIS at 12, 18, 24 and 30 months post-implantation. For a subgroup of 25 children language was assessed longitudinally and additionally by 45 min spontaneous speech samples per data point. RESULTS: Correlational analyses showed high concurrent validity between the questionnaire measures of vocabulary, inflectional morphology, sentence complexity, as well as the subscales of inflectional morphology and the corresponding language measures based on spontaneous speech. Descriptive statistics for the course of language development indicated a wide distribution of children across language levels. CONCLUSIONS: The parental questionnaire FRAKIS is a valid instrument for assessing language levels in children with CI. In assessing these children it is recommended that they are compared with values within this population.

Cochlear-implanted children from homes where English is an additional language: findings from a recent audit in one London centre.

A 5-year retrospective audit of demographic, audiological, and other records of 147 children implanted at one London centre was conducted. The aim was to detail the number of children implanted, with a specific focus on children from families with English as an additional language (EAL), and to compare these children with children from monolingual English-speaking families on a variety of characteristics known to affect paediatric cochlear implant outcomes. In all, 28% of children were from families where English is an additional language, with 15 different languages recorded. There were no differences between EAL and English-speaking children with respect to age of implantation; bilateral versus unilateral implants or hearing levels in better ear. There were differences between these groups in aetiology, in the occurrence of additional needs, and in educational placements. Information about speech and language outcomes was difficult to gather. Conclusions indicate the need for more detailed record-keeping especially about children's home languages for purposes of planning intervention and for the inclusion of children with EAL in future studies.

Language acquisition in young German-speaking children with cochlear implants: individual differences and implications for conceptions of a 'sensitive phase'.

The acquisition of language was studied longitudinally in a sample of 22 German-speaking children with cochlear implants (mean implantation age 29 months) and a control group of 22 normally hearing children. Spontaneous speech samples were collected over 27-36 months, starting at the the one-word stage. Results indicate that grammatical progress as measured by mean length of utterance was slower for cochlear-implanted children. However, there were substantial individual differences in the cochlear-implanted group. While 10 cochlear-implanted children progressed at pace with normally hearing children, 12 cochlear-implanted children remained well behind. Cochlear-implanted children who showed fast progress at an early stage continued to make fast progress as time went on, and those who showed slow progress early on continued to progress slowly. Pre-operative hearing was a better predictor of subsequent linguistic growth than age at implantation. Increases in vocabulary were associated with grammatical progress in both groups.

The acquisition of grammatical and lexical structures in children with cochlear implants: a developmental psycholinguistic approach.

The acquisition of grammatical and lexical structures was studied in a sample of 10 young German-speaking children with cochlear implants (mean implantation age 2 years 3 months). Spontaneous speech samples were collected covering the first 18 months after first tune-up. At the end of this period, 8 children were able to produce two- or multi-word utterances. Furthermore, 8 children had acquired plural inflections on nouns, and 5 children had acquired a substantial portion of verb inflectional morphology. Children did less well acquiring case-marked articles, forms of the copula and modal verbs. Articles were acquired better when they functioned as pronouns. Children had good vocabularies (type/token ratios >/=0.25), and all but one child started language with a preference for content words as opposed to function words.

Some aspects of language development in normal-hearing children and children with cochlear implants.

OBJECTIVE: This article presents some important processes of normal child language acquisition and applies them to language acquisition data of children with cochlear implants. DATA SOURCES: Modern studies of language acquisition, covering various languages, have demonstrated a close link between linguistic and cognitive development. Sensorimotor intelligence provides a construction of reality on which the first grammatical structures are built, encoding a number of relations which hold between objects, persons, events, and localizations. When acquiring the more complex morphological and syntactic aspects of their mother-tongue, children use a number of characteristic information processing strategies which make some formal markings easier to learn than others. There is considerable variability across children with respect to rate of acquisition, the use of imitation, and analytic versus holistic processing strategies. Caregivers' language input can facilitate language acquisition, notably the use of expansions and reformulations, and a generally accepting style. EMPIRICAL STUDY OF CHILDREN WITH COCHLEAR IMPLANTS: Language acquisition data from two children with cochlear implants show great differences with respect to rate of acquisition, construction of the German case system, and syntax. Whereas one child discovers the regularities of the case inflectional system quickly, the other child appears to prefer holistic and rote learning processes and uses a sequential strategy for combining words. It is suggested that variability between children with cochlear implants may be due to different frequencies of actually processed linguistic items. CONCLUSIONS: Future research should compare language development in children with cochlear implants and those with normal hearing making use of psycholinguistic methods of research design and analysis.

A longitudinal study of the acquisition of language by two German-speaking children with cochlear implants and of their mothers' speech.

The development of language in two children with cochlear implants was analyzed using longitudinal data of videorecorded mother-child interactions. Recordings were made over a period of 14 months for child A and over a period of 3 years for child B. At the beginning of data collection the children were 2;11 and 3;7 respectively. Results reveal substantial differences between the two children and their mothers. Child B was slow in acquiring grammar, with vocalizations and non-linguistic communicative behavior persisting. The child also used language in a labeling function. Child B's MLU (mean length of utterance) never exceeded 2.7 morphemes and his syntax remained rudimentary. Child A had a highly imitative style at the beginning, but then progressed to the spontaneous use of multi-word utterances very quickly, reaching an MLU of 5.6 morphemes in less than 2 years. Child A progressed to correct morphology and a fairly complex syntax. The children's mothers differed with respect to their use of exaggerated intonation patterns, repetitions and expansions, the use of labeling, questions, and directives. Results are discussed in terms of the influence of children's information processing styles and mothers' speech input.

Children's understanding of the feeling experience and causes of sympathy.

German children in five age groups, 5-6, 7-8, 9-10, 11-12 and 14-15 years, were interviewed about feeling experiences of sympathy and situations that elicit sympathy. While the younger children focussed on the emotion of sadness, the older children increasingly described sympathy as a multi-dimensional emotional experience consisting of sadness, desire to help, and preoccupied thoughts about the other in distress. The most marked developmental change occurred in the frequency of reference to preoccupied thoughts. The older children regarded severe life-threatening distress as situations that elicit sympathy, whereas the younger children spontaneously named everyday life distress or favourite animals.