Speech and language development following ... - ResearchGate

C. Ouellet, H. Cohen / Journal of Neurolinguistics 12 (1999) 271±288 283phonological skills developed and phonetic/articulatory skills emerged beforeextending to everyday speech. The phonological level followed the phonetic one.This is in agreement with Miller [42], who found that the impairment caused byprelingual deafness may be restricted to the phonological aspects of language.7. Psychosocial impactsTait [77] reported an increase in eye contact and vocal turn-taking, as well as adecrease in gesture in 10 children after 12 months of cochlear implant experience.This enhancement of attention and involvement apparently permitted better verbalcommunication. Tait and Lutman [78] also found a propensity towards a vocal/auditory communication style in implantees. However, despite these changes incommunication modality, implanted children may continue to use signs incombination with vocalizations to communicate [62].Cochlear implants can also in¯uence the social behavior and social competenceof hearing-impaired people, who may lack peer acceptance and have lessdeveloped social abilities. Although some data suggest that young implantees maysometimes remain immature in their social interactions with hearing peers [31],other results show that cochlear implants improve interpersonal communicationskills and social con®dence and also reduce the user's social anxiety [26]. Severalpositive impacts of cochlear implants on the behavior of deaf children, whofrequently have behavior problems and are often impulsive and rigid [69], havebeen noted [13,40]. These improvements, however, may not always be maintainedover time and systematic investigations are still needed [62]. Good performers withcochlear implants will still encounter some linguistic diculties a€ecting theirinterpersonal interactions [46], despite changes in their communication mode.Cochlear implantation also has varied in¯uences on how parents communicatewith their implanted children. Six months after the operation, some mothers mayno longer use signs with their implanted child ([62], but see [31]). No matter how,cochlear implants do a€ect communication practices and not alwayssystematically. Nevertheless, these implants favor a variety of communicationstrategies and thus an enhanced mutual understanding. However, they have notbeen found to be e€ective in reducing parental anxiety. Parenting stress does notnecessarily decrease postoperatively Ð it may even increase. This may be due tounrealized expectations, the necessity of parental involvement in auralrehabilitation and restrictions in the pursuit of the parent's personal activities [63].8. RehabilitationSupport from home and school, training, (re)habilitation and education areessential factors that determine linguistic improvement [11] and permit theachievement of adequate phonetic and phonological competencies. Animplantation should be performed only if the cochlear implant center can o€er