The aim of this study was to examine prelinguistic vocal development in very young cochlear implant recipients. A prospective longitudinal research design was used to observe the sequence and time-course of vocal development in seven children who were implanted between 10 and 36 months of age. Speech samples were collected twice before implant activation and on a monthly basis thereafter for up to 2 years. Children's vocalizations were classified according to the levels of the Stark Assessment of Early Vocal Development-Revised (SAEVD-R; Nathani, Ertmer, & Stark, in press). The main findings were (a) six of seven children made advancements in vocal development after implantation, (b) children implanted between 12 and 36 months progressed through SAEVD-R levels in the predicted sequence whereas a child implanted at a younger age showed a different sequence, (c) milestones in vocal development were often achieved with fewer months of hearing experience than observed in typically developing infants and appeared to be influenced by age at implantation, and (d) in general, children implanted at younger ages completed vocal development at younger chronological ages than those implanted later in life. Clinical indicators of benefit from implant use were also identified.
Keywords
COCHLEAR IMPLANTS; CHILDREN; VOCAL DEVELOPMENT; SPEECH PRODUCTIONCochlear implants (CIs) have been shown to increase hearing sensitivity and improve auditory speech perception, speech production, and language ability in preschool and school-age children (e.g., ASHA, 2004;Blamey, Barry, & Jacq, 2001;Fryhauf-Bertschy, et al., 1997;Svirsky, Robbins, Kirk, Pisoni, & Miyamoto, 2000). Currently, however, little is known about the initial phases of speech development in very young implant recipients. Prelinguistic vocal development (hereafter referred to as "vocal development") is a process by which infants and toddlers produce increasingly diverse and adult-like utterances before they say words on a regular basis. For very young CI recipients, advancements in vocal development are likely to be among the first observable indications of increased hearing sensitivity and improved speech perception ability. That is, barring motoric, cognitive, or persistent technological problems, infants and toddlers with CIs should make progress in vocal development before words dominate their spoken output.
Typical and Atypical Patterns of Vocal DevelopmentThe process of vocal development in typically developing infants and toddlers has been characterized as consisting of overlapping stages during which new vocalization types NIH Public Access
NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript emerge and become common (See Vihman, 1996 for review). For example, Stark (1980) proposed a five level model in which infants progressed from Reflexive sounds (e.g., cry and discomfort sounds) to Cooing (i.e., the voluntary productions of comfort sounds in the velar area), to Vocal Play (i.e., sounds showing increased control of phonation and art...