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Bilingualism is common throughout the world, and bilingual children regularly develop into fluently bilingual adults. In contrast, children with cochlear implants (CIs) are frequently encouraged to focus on a spoken language to the exclusion of sign language. Here, we investigate the spoken English language skills of 5 children with CIs who also have deaf signing parents, and so receive exposure to a full natural sign language (American Sign Language, ASL) from birth, in addition to spoken English after implantation. We compare their language skills with hearing ASL/English bilingual children of deaf parents. Our results show comparable English scores for the CI and hearing groups on a variety of standardized language measures, exceeding previously reported scores for children with CIs with the same age of implantation and years of CI use. We conclude that natural sign language input does no harm and may mitigate negative effects of early auditory deprivation for spoken language development.

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In American Sign Language (ASL), conjunction ('and') and disjunction ('or') are often conveyed by the same general use coordinator (transcribed as "coord"). So the sequence of signs mary want tea coord coffee can be interpreted as 'Mary wants tea or coffee' or 'Mary wants tea and coffee' depending on contextual, prosodic, or other lexical cues. This paper takes the first steps in describing the syntax and semantics of two general use coordinators in ASL, finding that they have a similar syntactic distribution to English coordinators and and or. Semantically, arguments are made against an ambiguity approach to account for the conjunctive and disjunctive readings; instead, I propose a Hamblin-style alternative semantics where the disjunctive and conjunctive force comes from external quantification over a set of alternatives. The pragmatic consequences of using only a prosodic distinction between disjunction from conjunction is examined via a felicity judgement study of scalar implicatures. Results indicate decreased scalar implicatures when coord is used as disjunction, supporting the semantic analysis and suggesting that the contrast of lexical items in the and, or scale plays an important role in its pragmatics. Extensions to other languages with potential general use coordination are discussed.

Objectives: To determine if children with laryngeal penetration on videofluoroscopic swallow study (VFSS) who received feeding interventions (thickened liquids, change in liquid flow rate and/or method of liquid delivery) had improved symptoms and decreased hospitalizations compared to those without intervention. Methods: We performed a retrospective cohort study of children under 2 years with laryngeal penetration on VFSS at our institution in 2015 to determine initial and follow-up VFSS findings, symptom improvement at follow-up, and hospitalization risk before and after VFSS. Proportions were compared with Fisher's exact test and hospitalizations with paired t-tests. Results: We evaluated 137 subjects with age 8.93±0.59 months who had laryngeal penetration without aspiration on VFSS. 55% had change in management, with 40% receiving thickening and 15% a change in flow rate. There was significant improvement in symptoms for children that had feeding intervention and this improvement was greatest with thickening (OR 41.8, 95% CI 12.34-141.69, p<0.001). On repeat VFSS, 26% had evidence of aspiration that was not captured on initial VFSS. Subjects had decreased total and pulmonary hospitalizations with feeding intervention and decreased pulmonary nights with thickening (p<0.05). Conclusions: Laryngeal penetration appears to be clinically significant in children with oropharyngeal dysphagia and interventions to decrease its occurrence are associated with improved outcomes including decreased symptoms of concern and hospitalization nights. Thickening or other feeding intervention should be considered for all symptomatic children with laryngeal penetration on swallow study.