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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
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Acknowledgements
• Dr. Janice Gatty: Colleague and co-author• Office of development, the Clarke Schools for
the Deaf: provided many pictures
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Premises1. Deaf children 90% have hearing,
speaking parents
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Premises2. Aids & implants viable hearing
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Premises3. Hearing deficits intervention
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Premises4. Intervention mostly via parents
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Premises5. Spoken language:
Speech only a mediumCognition the basisSocial cognition the need
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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
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Child development.Nature or Nurture?
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Child development
NurtureNature
?
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Child development -
NurtureNatureInter-action
- nature/nurture interaction
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Child development Environment
Social
Child
LanguagePhysical
Development
ReactionAction
Sensori-motor
PerceptualCognitive
SocialLinguistic
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ChildDevelopment
CognitiveSocial
LinguisticSensori-motor
Perceptual
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ChildDevelopment
CognitiveSocial
Linguistic
Speech without language? Language without cognition?Language without social cognition?
Meaningless
Impossible
Useless
Sensori-motor
Perceptual
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Child development -
NurtureNatureInter-action
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Hearing loss is a deficit of nature
NurtureNatureInter-action
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Aids/implants remove the deficit
NurtureNature Inter-action
Residualhearing deficit
reduce
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Compensation for residual deficit requires enhanced nurture
NurtureNature Inter-action
Residualhearing deficit
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Aural habilitation 1. Best hearing capacity2. Best hearing skill3. Best use of hearing for:
Cognitive developmentSocial developmentLanguage development
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Cognitive, social-cognitive, and linguistic development
The child as “scientist”
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Scientific method
Observation
Theory
Prediction
Experiment
Results
Yes
No As Predicted
?
Growing knowledge
Prediction
Theory
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Child development
Experiment
Results
Yes
No As Predicted
?
Prediction
Theory
Observation
Cognition, social cognition, language
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Experiment
Results
Yes
No As Predicted
?
Prediction
Theory
Observation
Cognition, social cognition, language
Child development
Nature
EnhancedNurture
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The many layers of spoken
language
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Spoken Language
Physical, Social, Language ContextTalker intent
Surface meaningSentences
WordsSounds
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Phonology
Vocabulary
Grammar
Semantics
Pragmatics
Purpose
Language Cognition Social CognitionSensorimotor
function
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Speech withoutlanguage?
Language withoutcognition?
Language withoutsocial-cognition?
Meaningless
Impossible
Useless
Language
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The infant’s learning environment
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Early child development Environment
Social
Child
LanguagePhysical
DevelopmentSensori-motor
PerceptualCognitive
SocialLinguistic
FamilyHome Language
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Child
Indirect intervention
Therapist/teacher Family
Direct Intervention
Indirect Intervention
Direct Intervention
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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
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0
Indirect intervention
Information
EducationDemonstrationCoaching
Empower-ment
Evaluation
Explanation
Observation
Listening
SupportDiagnosis
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Direct intervention:Associations and connections
Sounds
Events
ObjectsMove-ment
Concepts
WordsSent-ences
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Direct interventionTherapist child Parent child
MovingFeelingSeeing
HearingSound-event association
Sensorimotor, Perceptual,Cognitive, Linguistic
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Cognition and language
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Social cognition
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Video here
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CognitionGeneral Social
LanguageKnowledge Use
SpeechHearing Producing
Role of positive feedback
Self
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Hearing deficit
CognitionGeneral Social
LanguageKnowledge Use
SpeechHearing Producing
Self
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CognitionGeneral Social
LanguageKnowledge Use
SpeechHearing Producing
Enhanced nurture
Self
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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
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Grazie