childhood hearing loss and the development of spoken language

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Childhood hearing loss and the development of spoken language Sordità e svilluppo del linguaggio parlato Arthur Boothroyd Presented during short course on Childhood Deafness and Language Amplifon Center for Research and Study Milan, October 2012 Director: Edoardo Arslan University of Padua

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Page 1: Childhood hearing loss and the development of spoken language

Childhood hearing loss and the development of spoken language

Sordità e svilluppo del linguaggio parlato

Arthur BoothroydPresented during short course onChildhood Deafness and Language

Amplifon Center for Research and StudyMilan, October 2012

Director: Edoardo ArslanUniversity of Padua

Page 2: Childhood hearing loss and the development of spoken language

Acknowledgements

• Dr. Janice Gatty: Colleague and co-author• Office of development, the Clarke Schools for

the Deaf: provided many pictures

Page 3: Childhood hearing loss and the development of spoken language

Premises1. Deaf children 90% have hearing,

speaking parents

Page 4: Childhood hearing loss and the development of spoken language

Premises2. Aids & implants viable hearing

Page 5: Childhood hearing loss and the development of spoken language

Premises3. Hearing deficits intervention

Page 6: Childhood hearing loss and the development of spoken language

Premises4. Intervention mostly via parents

Page 7: Childhood hearing loss and the development of spoken language

Premises5. Spoken language:

Speech only a mediumCognition the basisSocial cognition the need

Page 8: Childhood hearing loss and the development of spoken language

Premises1. Deaf children 90% have hearing,

speaking parents2. Aids & implants viable hearing 3. Hearing deficits intervention4. Intervention mostly via parents5. Spoken language:

Speech only a medium Cognition the basis Social cognition the need

Page 9: Childhood hearing loss and the development of spoken language

Child development.Nature or Nurture?

Page 10: Childhood hearing loss and the development of spoken language

Child development

NurtureNature

?

Page 11: Childhood hearing loss and the development of spoken language
Page 12: Childhood hearing loss and the development of spoken language

Child development -

NurtureNatureInter-action

- nature/nurture interaction

Page 13: Childhood hearing loss and the development of spoken language

Child development Environment

Social

Child

LanguagePhysical

Development

ReactionAction

Sensori-motor

PerceptualCognitive

SocialLinguistic

Page 14: Childhood hearing loss and the development of spoken language

ChildDevelopment

CognitiveSocial

LinguisticSensori-motor

Perceptual

Page 15: Childhood hearing loss and the development of spoken language

ChildDevelopment

CognitiveSocial

Linguistic

Speech without language? Language without cognition?Language without social cognition?

Meaningless

Impossible

Useless

Sensori-motor

Perceptual

Page 16: Childhood hearing loss and the development of spoken language

Child development -

NurtureNatureInter-action

Page 17: Childhood hearing loss and the development of spoken language

Hearing loss is a deficit of nature

NurtureNatureInter-action

Page 18: Childhood hearing loss and the development of spoken language

Aids/implants remove the deficit

NurtureNature Inter-action

Residualhearing deficit

reduce

Page 19: Childhood hearing loss and the development of spoken language

Compensation for residual deficit requires enhanced nurture

NurtureNature Inter-action

Residualhearing deficit

Page 20: Childhood hearing loss and the development of spoken language

Aural habilitation 1. Best hearing capacity2. Best hearing skill3. Best use of hearing for:

Cognitive developmentSocial developmentLanguage development

Page 21: Childhood hearing loss and the development of spoken language

Cognitive, social-cognitive, and linguistic development

The child as “scientist”

Page 22: Childhood hearing loss and the development of spoken language

Scientific method

Observation

Theory

Prediction

Experiment

Results

Yes

No As Predicted

?

Growing knowledge

Prediction

Theory

Page 23: Childhood hearing loss and the development of spoken language

Child development

Experiment

Results

Yes

No As Predicted

?

Prediction

Theory

Observation

Cognition, social cognition, language

Page 24: Childhood hearing loss and the development of spoken language

Experiment

Results

Yes

No As Predicted

?

Prediction

Theory

Observation

Cognition, social cognition, language

Child development

Nature

EnhancedNurture

Page 25: Childhood hearing loss and the development of spoken language

The many layers of spoken

language

Page 26: Childhood hearing loss and the development of spoken language

Spoken Language

Physical, Social, Language ContextTalker intent

Surface meaningSentences

WordsSounds

Page 27: Childhood hearing loss and the development of spoken language

Phonology

Vocabulary

Grammar

Semantics

Pragmatics

Purpose

Language Cognition Social CognitionSensorimotor

function

Page 28: Childhood hearing loss and the development of spoken language

Speech withoutlanguage?

Language withoutcognition?

Language withoutsocial-cognition?

Meaningless

Impossible

Useless

Language

Page 29: Childhood hearing loss and the development of spoken language

The infant’s learning environment

Page 30: Childhood hearing loss and the development of spoken language

Early child development Environment

Social

Child

LanguagePhysical

DevelopmentSensori-motor

PerceptualCognitive

SocialLinguistic

FamilyHome Language

Page 31: Childhood hearing loss and the development of spoken language

Child

Indirect intervention

Therapist/teacher Family

Direct Intervention

Indirect Intervention

Direct Intervention

Page 32: Childhood hearing loss and the development of spoken language

Audiologist ParentAudiologist Parent

What you sayThe tests show that Mary has a hearing loss. Our

best estimate is that the loss is around 85dB which puts her in the severe category. Things

could be much worse. There’s a good chance she will do well with hearing aids. If it turns out that

the hearing loss is more serious, you needn’t worry because she can always be fitted with cochlear implants and we have been seeing

amazing results with children. Some of them seem almost like they have normal hearing.

Would you like me to explain the audiogram?

What they hear

DEAF

Page 33: Childhood hearing loss and the development of spoken language

0

Indirect intervention

Information

EducationDemonstrationCoaching

Empower-ment

Evaluation

Explanation

Observation

Listening

SupportDiagnosis

Page 34: Childhood hearing loss and the development of spoken language

Direct intervention:Associations and connections

Sounds

Events

ObjectsMove-ment

Concepts

WordsSent-ences

Page 35: Childhood hearing loss and the development of spoken language

Direct interventionTherapist child Parent child

MovingFeelingSeeing

HearingSound-event association

Sensorimotor, Perceptual,Cognitive, Linguistic

Page 36: Childhood hearing loss and the development of spoken language

Cognition and language

Page 37: Childhood hearing loss and the development of spoken language

Social cognition

Page 38: Childhood hearing loss and the development of spoken language

Video here

Page 39: Childhood hearing loss and the development of spoken language

CognitionGeneral Social

LanguageKnowledge Use

SpeechHearing Producing

Role of positive feedback

Self

Page 40: Childhood hearing loss and the development of spoken language

Hearing deficit

CognitionGeneral Social

LanguageKnowledge Use

SpeechHearing Producing

Self

Page 41: Childhood hearing loss and the development of spoken language

CognitionGeneral Social

LanguageKnowledge Use

SpeechHearing Producing

Enhanced nurture

Self

Page 42: Childhood hearing loss and the development of spoken language

Messages1. Aids/implants Best hearing capacity2. Early intervention + Capacity + Nurture

Natural development3. Enhanced nurture individual differences4. General + Social Cognition Language5. Language + hearing skill Spoken language6. Audiologist assess/assist7. Interventionist assess/guide/adapt8. Both assess outcome and communicate

Page 43: Childhood hearing loss and the development of spoken language

Grazie