Investigator s Abstract): The proposed study examines the effects of education and habilitation on the speech and language skills of perlingually deaf children who use a Nucleus 22-channel cochlear implant. It is hypothesized that the benefits obtained from the implant are directly related to the child's dependence on spoken language for communication and the amount of auditory, speech and language instruction a child receives post implant. The sample selected for study will be as homogenous as possible so that the effects of intervention can be most clearly examined. Criteria for inclusion in the sample include: Chronological age between 7 yrs 0 mos and 9 yrs 11 mos; between 4 and 5 years post implant; implanted at 2, 3, or 4 years of age; English as a first language; and normal intelligence. Over the 5-year period of this grant, 190 children who meet these criteria will be identified through responses to announcements in periodicals and newsletters and direct mailing of application materials by their cochlear implant centers and school programs. The children will be brought to St. Louis, along with a parent, in groups of 10 to 15 to participate in a 3-day summer camp/parent education experience. While the parents are involved in educational seminars, the children will be tested with an extensive battery of tests which have been carefully selected to provide estimates of four dependent variables: auditory skills (i.e., speech perception and visual enhancement), speech production skills (phoneme and word intelligibility), spoken language skills (English language and functional communication) and reading skills (decoding and comprehension). For the dependent measures, each child's history of speech/auditory training and school communication mode will be obtained from questionnaires completed independently by the parents, the cochlear implant center, and the child's school. These measures will be analyzed using multivariate analysis, with important covariates such as IQ, family socioeconomic status, type of school program and support service, controlled for. Assuming that, for a perlingually deaf child, the purpose of cochlear implantation is the achievement of higher levels of spoken English and reading, it is critical to determine the extent to which these skills are affected by the kind of intervention that follows implantation. Since, for perlingually deaf children, the cost of the intervention program can easily exceed the cost of the implant, establishing the amount of training needed in relation to the amount of benefit achieved with an implant has considerable practical importance.
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