Psychosocial Development and CI

jillio

jillio

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We started a discussion on this topic in another thread, but since it wa a bit off topic, I thought I would start a new thread. I found an interesting article publishd in Child: care,health, & development (2002). 28(5), 403-418.

This was a follow up (longitudinal) study on implanted children and their psychosocial development and interaction with peers. It supports my concerns about the psychological and social development of implanted children, and the impact that such has educationally.

The results showed that all of the children could perceive environmental sounds after implantation. The majority could participate in simple oral conversations when the context was well known. This was acheived more easily in the home than in a school setting. Observations from the preschools showed that the children had been using their implants from 1-3.5 years and did not interact with other children or adults by means of speech and hearing. They did not take an active part in role or fantasy play with peers who did not have a command of sign. As peer interactions were limited, they interacted mostly with signing adults, and these adults often assumed the role of interpreter for both other children and adults. Therefore, the children were socially deaf. These findings supported a study from 1999 that sought to determine whether CI used by prelingually deaf children would result in greater social competence. The results did not show any improvement in the social competence of the impalnted children. The coclusion was that they experience the same difficulties in this situation as other deaf and HH children and teens, and this is also what HH adults have reported in their interviews about childhood experiences.

For language to develop, symbolic play has been shown to play an important role. To be able to interact with peers is important for the child's language development. Therefore, the situation for deaf children with CI in preschools where speech was the main language gives cause for apprehension. To have an adult act as interpreter/mediator seldom promeotes friendship, and normal peer relations become almost impossible. The importance of considering children's total social reality in relation to later developmental outcomes is maintained by many developmental psychologists.
 
 
Hi Jillio,

Thanks for sharing that with us. If your point is that CI children still need to be supported with their peer relationships, expressive language etc then I would agree with you.

You may also be interested in a research article by Yael Bat Sheva published in 2001, which looks in detail at the peer relationships of those with CIs. She did find that relationships improved with other hearing children but of course it still wasn't perfect and they still faced obstacles. You can read the full text here -:
Peer Relationships of Children With Cochlear Implants -- Bat-Chava and Deignan 6 (3): 186 -- The Journal of Deaf Studies and Deaf Education

Abstract:

Peer Relationships of Children With Cochlear Implants
Yael Bat-Chava and Elizabeth Deignan

League for the Hard of Hearing

Previous research on children with cochlear implants has focused mostly on their speech perception and production. With the growing numbers of children who use the implant, it is important to assess other aspects of these children's functioning. This article offers a qualitative and quantitative analysis of interviews with parents who described their children's communication skills and peer relationships before they had the implant and afterward. Results show that the implant has the potential to improve deaf children's relationships with hearing peers. Nonetheless, children with implants still face communication obstacles, which impede their social relationships with hearing peers. Results are discussed in light of the different points of view of various "stake holders" regarding cochlear implants in children.
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his was acheived more easily in the home than in a school setting.
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Well that's b/c parents tend to hyperenunciate what they are saying. The general public doesn't. Some of them do modify their voices when talking to dhh people, but most don't!
 
deafdyke said:
Well that's b/c parents tend to hyperenunciate what they are saying. The general public doesn't. Some of them do modify their voices when talking to dhh people, but most don't!
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Actually I think it's reflective of the bond and degree of attachment that the family has with the dhh child. Other hearing people aren't sure how to take DHH children and therefore will not interact with them as much as someone who has normal hearing. Families however know their children and that results in the greater oral interaction that we see in these studies.

I never felt that my own family hypernunciated with me. They just knew me. Same with all my hearing friends today. They *know* me and know exactly what I am about. But with strangers I can see the hesitation to begin with, which then dissipates when they get to know me as a person.
 
Boult said:
R2D2, that's why I mentioned this in other thread about Cecila's Story where she has siblings helping her as well as her parent.
http://www.alldeaf.com/hearing-aids...-choose-cis-their-children-15.html#post749219

and in Cloggy's Lotte has siblings so she is getting some helps and does socialize with her own friends.

and so on...
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Cool, that reflects my own family growing up. In some ways, that is why it's valuable to have oral skills because of the bond with the family and extended family, which I feel is important to mental development.
 
R2D2 said:
Cool, that reflects my own family growing up. In some ways, that is why it's valuable to have oral skills because of the bond with the family and extended family, which I feel is important to mental development.
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Really? That's awesome for u. In my case, I had a good bond with my mom and brother only despite having good oral skills.my extended family didn't really take the time to ensure that I was kept in the loop of what everyone is saying. Even with one on one situations, I got the feeling that they dumbed down their talk. I honestly don't know my aunts, uncles or cousins very well. I did my part but I can only do so much. Maybe that's why I feel more connected with my deaf friends than I do with them except for my mom and deaf brother. I have 4 other brothers who are hearing andthey are practically strangers to me even though I can understand them and they can understand me. With my deaf brother who has absulotely no oral skills, there is absulotely no connection with him and our family members due to the big communication barrier. They can learn sign but guess it was too much trouble so my brother is the one who suffers being isolated in family gatherings.

If the deaf child is unable to develop oral skils no matter how hard they and the family tries and the family doesn't learn sign language, what is that?

I know sooo many of my friends, students and even my own brother in that situation with their families. Why is it that the deaf children must always learn oral skills but the families don't have to learn ASL? Why can't everyone do both? Teach the deaf children oral skills but the family take the time to learn sign language? That's just a burning question I have and it frustrates me to see that happening too often.

Oh well..nothing I can do about it only to express how I feel about it.
 
shel90 said:
I know sooo many of my friends, students and even my own brother in that situation with their families. Why is it that the deaf children must always learn oral skills but the families don't have to learn ASL? Why can't everyone do both? Teach the deaf children oral skills but the family take the time to learn sign language? That's just a burning question I have and it frustrates me to see that happening too often.
it.
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Yes the reality - that if a child has ASL that usually only the mother learns it and everyone else only knows a few to get by with a simple conversation.

Why?

1. It requires time and commitment - regular classes over years in order to achieve fluency. In this time the child will have easily overtaken the parents and stays at a more advanced level. Some parents are bothered by this.

2. The difficulty of learning a foreign language generally - ASL is similar to other foreign languages in complexity. Many people struggle in learning a new language other than their own particularly when they are adults. Children have a much greater capacity to absorb a new language.

3. Lack of opportunities to practice with anyone other than the child - unless they join the local deaf community (assuming there is one nearby) and go along there frequently. The deaf child may also live in at their schools - reducing opportunities for parents to practice. I notice with my hearing niece that she fingerspells a lot to my nephew, even though receptively she understands sign - it's due to the fact of lack of practice. You probably know that language is learned fastest by complete immersion.

Parents like Jillio who have almost adopted the deaf culture are uncommon. Jillio, if you are reading this, how many of your extended family have also learned to sign, out of interest?

It may not seem fair but that's the reality and social policy has to take account of this. They want the best outcome that can be provided with the givens that over 90% of children are born to hearing parents.
 
R2D2 said:
Yes the reality - that if a child has ASL that usually only the mother learns it and everyone else only knows a few to get by with a simple conversation.

Why?

1. It requires time and commitment - regular classes over years in order to achieve fluency. In this time the child will have easily overtaken the parents and stays at a more advanced level. Some parents are bothered by this.

2. The difficulty of learning a foreign language generally - ASL is similar to other foreign languages in complexity. Many people struggle in learning a new language other than their own particularly when they are adults. Children have a much greater capacity to absorb a new language.

3. Lack of opportunities to practice with anyone other than the child - unless they join the local deaf community (assuming there is one nearby) and go along there frequently. The deaf child may also live in at their schools - reducing opportunities for parents to practice. I notice with my hearing niece that she fingerspells a lot to my nephew, even though receptively she understands sign - it's due to the fact of lack of practice. You probably know that language is learned fastest by complete immersion.

Parents like Jillio who have almost adopted the deaf culture are uncommon. Jillio, if you are reading this, how many of your extended family have also learned to sign, out of interest?

It may not seem fair but that's the reality and social policy has to take account of this. They want the best outcome that can be provided with the givens that over 90% of children are born to hearing parents.
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Yea, I know...still it is a shame anyway. Like I said..oh well.
 
 
R2D2 said:
Hi Jillio,

Thanks for sharing that with us. If your point is that CI children still need to be supported with their peer relationships, expressive language etc then I would agree with you.

You may also be interested in a research article by Yael Bat Sheva published in 2001, which looks in detail at the peer relationships of those with CIs. She did find that relationships improved with other hearing children but of course it still wasn't perfect and they still faced obstacles. You can read the full text here -:
Peer Relationships of Children With Cochlear Implants -- Bat-Chava and Deignan 6 (3): 186 -- The Journal of Deaf Studies and Deaf Education
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Thanks! I've alread read that one. And yes, my point is that peer relationships still need to be supported through the use of a bi-bi environment. The language difficulties experienced by children who are expected to perform on an oral basis only interfere with their ability to form relationships and thus interfer with psychosoical development.
 
deafdyke said:
Well that's b/c parents tend to hyperenunciate what they are saying. The general public doesn't. Some of them do modify their voices when talking to dhh people, but most don't!
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And also not so many visual distractions.
 
Just got back to this. My mother and my father both learned to sign decently, my brother did not learn sign but both of his sons did, and I am in the process of teaching their babies sign now. My husband was learning, but did not have time to become fluent prior to his death. As my parents, my parents-in-law, my brother, and my husband are all dead, my nephews and their children are mine and my son's only remaining extended family. That is another reason the the connection tothe deaf community ha been valuabe for my son.
 
Jillio - I agree with you that implanted children need to be supported and allowed to develop peer relationships with others like them. Parents need to learn from the past and be aware that this is potentially a difficult area for deaf children where involvement and intervention may be needed. I'm not sure if BiBi is the only valid way to do this though and I'm getting the impression that BiBi programs are not very widespread. I do think that it's possible for an involved parent of a child in an oral environment to help develop their child's self esteem both at school and out of school, although I recognise that this involves commitment and a challenge. The problem in the past has been that people haven't taken self esteem very seriously or realised that it was an important issue.

I found another study with quite a large sample of children this time.

Personal, Social, and Family Adjustment in School-Aged Children with a Cochlear Implant.

Article
Ear & Hearing. 24(1) Supplement:69S-81S, February 2003.
Nicholas, Johanna G.; Geers, Ann E.

Abstract:
Objective: The present study sought to document the psycho-social adjustment of 181 school-aged deaf children who have had a cochlear implant for 4 or more yr and to examine parental satisfaction with the outcome of the implantation process on their child's life and on their family's life in general.

Design: Three measures were employed. One measure was a self-report instrument designed to assess perceived self-competence in children, one was a rating scale completed by parents that sought to assess the degree of their child's personal-social adjustment, and the third was a questionnaire given to parents on which they rated their satisfaction with aspects of the cochlear implant and how it had affected their child's functioning within the context of family life.

Results: Children generally perceived themselves (and parents perceived their children) as being competent and well adjusted in most aspects of daily life. Parents expressed a generally positive view of cochlear implantation and its effects on family life. None of the social-emotional adjustment measures was significantly related to the speech perception, speech production or language skills the child achieved postimplant. However, the parents' satisfaction with their child's cochlear implantation was significantly related to their child's speech and language achievements. On the perceived self-competence instrument, younger children and those with longer use of the updated SPEAK speech processor gave themselves higher ratings. Parent ratings of their child's adjustment tended to be higher for girls than for boys, for more rather than less intelligent children, and for children enrolled in private as opposed to public school settings.

Conclusions: Deaf children who have used a cochlear implant for 4 to 6 yr report that they are coping successfully with the demands of their social and school environment, regardless of their speech and language achievements after implantation. Parents' ratings indicate that these children are emotionally and socially well adjusted and that they have benefited from cochlear implantation. To the extent that the children and their parents accurately reported their attitudes and feelings regarding their experiences at home and at school, these results represent an impressive level of personal and social adjustment when compared with previous literature on adjustment problems in deaf children. The extent to which these results are associated with cochlear implantation has not been determined and awaits comparative data from children without implants.
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Source: Ear and Hearing - Abstract: Volume 24(1) February 2003 p 69S-81S Personal, Social, and Family Adjustment in School-Aged Children with a Cochlear Implant.
 
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jillio said:
Just got back to this. My mother and my father both learned to sign decently, my brother did not learn sign but both of his sons did, and I am in the process of teaching their babies sign now. My husband was learning, but did not have time to become fluent prior to his death. As my parents, my parents-in-law, my brother, and my husband are all dead, my nephews and their children are mine and my son's only remaining extended family. That is another reason the the connection tothe deaf community ha been valuabe for my son.
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That is lovely that the whole family got involved :) Thanks for answering my question.
 
R2D2 said:
That is lovely that the whole family got involved :) Thanks for answering my question.
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Not a problem. I, too was very touched that they went out of their way to interact with my son on his own terms. I have a great deal of gratitude for the fact that I was blessed with such a giving, open minded, and accepting family.
 
jillio said:
Not a problem. I, too was very touched that they went out of their way to interact with my son on his own terms. I have a great deal of gratitude for the fact that I was blessed with such a giving, open minded, and accepting family.
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Your son is just so lucky..families like yours are so rare cuz most people are not as motivated in general.
 
well i think its a combonation of both what you said and what i said..............i mean a lot of the general public aren't too aware of how to interact with a dhh person.........like i remember when i would return back to college and back to overnite camp and things like that, i'd have to remind everyone about how to interact with a dhh person. also it would always take a few days for them to get used to my voice again.
 
deafdyke said:
well i think its a combonation of both what you said and what i said..............i mean a lot of the general public aren't too aware of how to interact with a dhh person.........like i remember when i would return back to college and back to overnite camp and things like that, i'd have to remind everyone about how to interact with a dhh person. also it would always take a few days for them to get used to my voice again.
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Yea, it took me longer for the other parents of my daughter's teammates to feel comfortable chatting with me. Finally, they are comfortable and the season is over as of today! That's like 3 months of them getting used to me..I really did go out there and greet them, watched and listened to their conversations to the best of my abilities and jumped in when I knew what they were talking about, and initiated conversations but yet it took a while for them to really start coming up to me. In an signing environment, I dont encounter that problem whether the people are deaf or hearing. I have to do a lot of work and sometimes it is worth it like this situation but sucks that it ended when it was just starting to get good. GRRRRR!

Before, when I was assimilated fully in a hearing world without knowing sign language, it was always frustrating working that hard all time time but now that I have my signing part of my life, so it is not as frustrating anymore. It is because I have a good balance now so I dont get really depressed about it anymore. :)
 
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