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Synchrony of Maternal Auditory and Visual Cues About Unknown Words to Children With and Without Cochlear Implants

Lund, Emily1; Schuele, C. Melanie2

doi: 10.1097/AUD.0000000000000104
Research Articles
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Objectives: The purpose of this study was to compare types of maternal auditory–visual input about word referents available to children with cochlear implants, children with normal hearing matched for age, and children with normal hearing matched for vocabulary size. Although other works have considered the acoustic qualities of maternal input provided to children with cochlear implants, this study is the first to consider auditory–visual maternal input provided to children with cochlear implants.

Design: Participants included 30 mother–child dyads from three groups: children who wore cochlear implants (n = 10 dyads), children matched for chronological age (n = 10 dyads), and children matched for expressive vocabulary size (n = 10 dyads). All participants came from English-speaking families, with the families of children with hearing loss committed to developing listening and spoken language skills (not sign language). All mothers had normal hearing. Mother–child interactions were video recorded during mealtimes in the home. Each dyad participated in two mealtime observations. Maternal utterances were transcribed and coded for (a) nouns produced, (b) child-directed utterances, (c) nouns unknown to children per maternal report, and (d) auditory and visual cues provided about referents for unknown nouns. Auditory and visual cues were coded as either converging, diverging, or auditory-only.

Results: Mothers of children with cochlear implants provided percentages of converging and diverging cues that were similar to the percentages of mothers of children matched for chronological age. Mothers of children matched for vocabulary size, on the other hand, provided a higher percentage of converging auditory–visual cues and lower percentage of diverging cues than did mothers of children with cochlear implants. Groups did not differ in provision of auditory-only cues.

Conclusions: The present study represents the first step toward identification of environmental input characteristics that may affect lexical learning outcomes of children with cochlear implants. Given that children with cochlear implants demonstrate slower rates of lexical growth than children with normal hearing, the findings from this study provide an important direction for further investigation of how environmental factors affect lexical outcomes for this population. If mothers can provide auditory and visual cues to increase the salience of a relevant object in word-learning contexts, they may be able to facilitate the language growth of their children.

This study examined maternal auditory and visual cues about word referents available to children with cochlear implants as compared to those available to children with normal hearing matched for chronological age and children matched for vocabulary level. Mother-child interactions were video-recorded during mealtime. Interactions were coded for auditory and visual cues provided about referents. The results of this investigation indicate that mothers provide auditory-visual input to children with cochlear implants in a way that differs significantly from children matched for vocabulary size but not matched for chronological age.

1Department of Communication Sciences and Disorders, Texas Christian University, Fort Worth, Texas, USA; and 2Department of Hearing and Speech Science, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

This work would not have been possible without the financial support of a Preparation of Leadership Personnel grant (H325K080075; PI: Schuele) from the U.S. Department of Education and in part by the Vanderbilt CTSA grant TR 000445 from NCRR/NIH. Study data were managed using REDCap electronic data capture tools hosted at Vanderbilt University (1 UL1 RR024975 from NCRR/NIH).

The authors declare no other conflict of interest.

Address for correspondence: Emily Lund, Department of Communication Sciences and Disorders, Texas Christian University TCU Box 297450, Fort Worth, TX 76129, USA. E-mail: e.lund@tcu.edu

Received March 6, 2014; accepted August 6, 2013.

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