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284C. Ouellet, H. Cohen / Journal of Neurolinguistics 12 (1999) 271±288multidisciplinary team support before the operation, as well as immediate andintensive speech rehabilitation in which both parents and teachers must cooperate[6]. These education and (re)habilitation services, which are important for adultsbut critical for children, should include technical and pedagogical training [32].This rehabilitation may take months [24] and lasts longer for prelingually thanpostlingually deaf patients [27]. Individual sessions of about 1.5 h at regular preandpostoperative intervals may be one way to provide language habilitation andeducational training [15]. Ling [35,36], however, advocates three-minute sessions,several times a day, to reach a level of automatic speech, thus permitting thetransfer of acquired speech patterns to everyday situations. No matter how thesetraining sessions are provided to patients, the techniques must be adapted tochildren and made available to parents or other individuals supporting youngcochlear implant users.To develop hearing and speech abilities, patients must receive adequatestimulation. The habilitation should focus on the use of audition to optimizelanguage development, including the improvement of speech and languageperception and production skills. Parents are encouraged to preferentially useaudition in their interactions with children [15] and guide them into auditoryverbaleducation and linguistic interactions on a daily basis [7]. Finally, either oral(speech plus listening) or total (signs plus speech and listening) modes ofcommunication may be applied.References[1] Amadori M, Pantano N, Cestaro A, Babighian G, et al. Considerations on the rehabilitation ofthe hearing in cochlear implant patients. Acta Otorhinolaryngologica Italia 1996;16:324±33.[2] Arauz SL, Aronson L, Mastroianni-Pinto SN, Preti MC, Pallante SA, Estienne PA, Ortega M.Multichannel cochlear implant in a deaf±blind patient. Audiology 1997;36:109±16.[3] Barthelemy P. The very young deaf child and his body: The relationship between the body withdevelopment of cognition, language, motor skills. Revue de Laryngologie Otologie Rhinologie1996;117:277±83.[4] Bates E. Language development. Current Opinions in Neurobiology 1992;2:180±5.[5] Berliner KI. Selection of cochlear implant patients. In: Schindler RA, Merzenich MM, editors.Cochlear Implants. New York: Raven Press, 1985.[6] Bertram B. Pedagogic aspects of rehabilitation of children with a cochlear implant. Report fromHannover Cochlear Implant Center. Wiener Medizinische Wochenschrift 1994;144:3±7.[7] Bertram B, Pad D. Importance of auditory-verbal education and parents' participation aftercochlear implantation of very young children. Annals of Otology, Rhinology and Laryngology1995;166(Supplement):97±100.[8] Chute PM. Cochlear implants in adolescents. Advances in Otorhinolaryngology 1993;48:210±5.[9] Clark G, Blamey PJ, Brown AM, Gusby PA, Dowell RC, Franz BK, Pyman BC, Shepherd RK,Tong YC, Webb RL, et al. The University of Melbourne-nucleus multi-electrode cochlear implant.Advances in Otology, Rhinology and Laryngology 1987;38:1±181.[10] Cohen NL. Cochlear implants. In: Bluestone CD, Stool SE, editors. Atlas of PediatricOtolaryngology, 1995.[11] Cohen NL, Waltzman SB. Cochlear implants: an overview and update. Otolaryngology Ð Headand Neck Surgery 1995;116:146±52.[12] Cohen NL, Waltzman SB, Roland Jr. JT, Bromberg B, Cambron N, Gibbs L, Parkinson W,
C. Ouellet, H. Cohen / Journal of Neurolinguistics 12 (1999) 271±288 285Snead C. Results of speech processor upgrade in a population of Veterans A€airs cochlear implantrecipients. American Journal of Otology 1997;18:462±5.[13] Corbetta LK, Danhauer JL, Prutting CA. A young meningitically deaf child with a cochlearimplant: a case study. International Journal of Pediatric Otorhinolaryngology 1990;20:25±43.[14] Dawson PW, Blamey PJ, Rowland LC, Dettman SJ, Clark GM, Busby PA, Brown AM, DowellRC, Rickards FW. Cochlear implants in children, adolescents and prelinguistically deafenedadults: speech perception. Journal of Speech and Hearing Research 1992;35:401±17.[15] Dawson PW, Blamey PJ, Dettman SJ, Barker EJ, Clark GM. A clinical report on receptive vocabularyskills in cochlear implant users. Ear and Hearing 1995;16:287±94.[16] Dawson PW, Blamey PJ, Dettman SJ, Rowland LC, Barker EJ, Tobey EA, Busby PA, CowanRC, Clark GM. A clinical report on speech production of cochlear implant users. Ear andHearing 1995;16:551±61.[17] Dehaene S, Dupoux E, Mehler J, Cohen L, Paulesu E, Perani D, van de Moortele PF, Lehericy S,Le Bihan D. Anatomical variability in the cortical representation of ®rst and second language.Neuroreport 1997;8:3809±15.[18] Fryauf-Bertschy H, Tyler RS, Kelsay DM, Gantz BJ. Performance over time of congenitally deafand postlingually deafened children using multichannel cochlear implants. Journal of Speech andHearing Research 1992;35:913±20.[19] Fryauf-Bertschy H, Tyler RS, Kelsay DM, Gantz BJ, Woodworth GG. Cochlear implant use byprelingually deafened children: the in¯uences of age at implant and length of device use. Journalof Speech and Hearing Research 1997;40:183±99.[20] Gantz BJ, Tyler RS, Knutson JF, Woodworth G, Abbas P, McCabe BF, Hinrichs J, Tye-MurrayN, Lansing C, Kuk F, et al. Evaluation of ®ve di€erent cochlear implant designs: audiologicassessment and predictors of performance. Laryngoscope 1988;98:1100±6.[21] Gantz BJ, Woodworth GG, Abbas PJ, Knutson JF, Tyler RS. Multivariate predictors of audiologicalsuccess with multi-channel cochlear implants. Annals of Otology, Rhinology andLaryngology 1993;102:909±16.[22] Geers AE, Moog JS. Early speech perception test. St. Louis: Central Institute for the Deaf, 1990.[23] Gray RF. Cochlear implants in children. In: Mo€at DA, editor. Otolaryngology, 1995.[24] Gray RF, Hawthorne M. Hearing aids. In: Gray RF, Hawthorne M, editors. Synopsis ofOtolaryngology, 5th ed., 1992.[25] Ho€man RA. Cochlear implant in the child under two years of age: Skull growth, otitis mediaand selection. Otolaryngology Ð Head and Neck Surgery 1997;117:217±9.[26] Hogan A. Implant outcomes: Towards a mixed methodology for evaluating the ecacy of adultcochlear implant programmes. Disability and Rehabilitation 1997;19:235±43.[27] Ito J, Fujino K, Shiomi Y, Takagi A, Takahashi H, Kawano M, Honjo I. Cochlear implants foradult prelingually deaf patients. Nippon Jibiinkoka Gakkai Kaiho 1994;97:2092±6.[28] Kileny PR, Zimmerman-Phillips S, Kemink JL. E€ects of active channel number and place ofstimulation on performance with multichannel implant. American Journal of Otology 1992;13:117.[29] Kirk KI, Pisoni DB, Osberger MJ. Lexical e€ects on spoken word recognition by pediatriccochlear implant users. Ear and Hearing 1995;16:470±81.[30] Knutson J, Hinrichs JV, Tyler RS, Gantz BJ, Schartz HA, Woodworth G. Psychological predictorsof audiological outcomes of multichannel cochlear implants: preliminary ®ndings. Annals ofOtology, Rhinology and Laryngology 1991;100:817±22.[31] Knutson JF, Boyd RC, Reid JB, Mayne T, Fetrow R. Observational assessments of the interactionof implant recipients with family and peers: preliminary ®ndings. Otolaryngology Ð Head andNeck Surgery 1997;117:196±207.[32] Lehnhardt E. Cochlear implant for children: indications and surgical aspects. Wiener MedizinischeWochenschrift 1994;144: 8±10, 12, 14.[33] Lehnhardt M, Reid J. Test results in European children with a Nucleus Mini System 22 cochlearimplant. Wiener Medizinische Wochenschrift 1994;144:23±7.[34] Lenarz T, Hartrampf R, Battmer RD, Bertram B, Lesinski A. Cochlear implant management ofyoung children. Laryngorhinootologie 1996;75:719±26.
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