Cochlear implantation and cued speech internationally

loml · 08-06-2007, 03:05 PM

Quote:

Anne Worsfold, Executive Director, Cued Speech Association UK

How can we ensure that implanted children reach their potential? Research and case studies from Europe and America suggest that the early and constant use of Cued Speech by family members and professionals can significantly improve the children's ability to benefit from the implant.
Cued Speech and Cochlear Implantation are frequently described as `perfect partners' because Cued Speech gives sound-by-sound access to spoken language by visual means, perfect for optimising language development prior to implantation and for supporting the child in the early years post implantation.

A French study (1) shows that children who had full and consistent exposure to Cued Speech prior to implantation performed considerably better in a number of tests than children brought up aurally or with French Sign Language. Tests showed that both three and five years after implantation Cued Speech children had significantly better:

perception of words in open lists
speech intelligibility (measured on the Nottingham scales).
In Spain Cued Speech is the norm in some cochlear implant centres with several specifically recommending its use. In addition, the Complemented Oral Model (Modelo Oral Complementada, MOC) project in southern Spain uses Cued Speech within an oral programme and many of the children in the programme are implanted (at present they have 20 children between 11 and 18 months). The aim is not just to provide first class support for the children but also to publish research. The programme has now been running for over twelve years and early results are outstanding, with some areas of linguistic development better than age appropriate.(2)

From America Jane Smith writes: `For nearly 20 years, I have been a communication specialist with deaf children who have cochlear implants (CIs). The vast majority of these deaf children use Cued Speech.

Although CIs have been an amazing breakthrough for the deaf, outcomes differ from child to child. I would not take the chance of denying a child a visual representation of spoken language until I was sure that they were learning everything through listening. Cued Speech helps clarify and verify what is heard; it actually accelerates the learning of language and listening.

Many deaf children who receive CIs perceive environmental sounds but progress in the perception of speech is much slower. Deaf children who use Cued Speech perceive speech more quickly.

Until recently, most of my students were receiving CIs after age three - after they had acquired language. I observed that children who used Cued Speech had a `phonological grid' already internalised when they began to listen with their CIs. They were able to learn auditorily what they had internalised visually already. Progress in learning to listen came quickly because they already had this internal grid of phonemes. Cued Speech helps children interpret the sounds they are hearing via electrical stimulation as the same sounds they are seeing through Cued Speech.

For children aged three and under who learn Cued Speech at the same time as they get their implant, Cued Speech is also a huge benefit. Cued Speech develops an internal phonological model of speech and language that facilitates reading later. The child not only hears but also sees syllables and stress patterns. A child can see morphological structures that are difficult to hear - plurals, possessives and tenses for example.

After a certain amount of time - which varies for all kids, Cued Speech children learn vocabulary and academic information through listening alone. Many parents drop the use of Cued Speech at home (except at bath time or at the pool) but continue to have their child use it in school in the mainstream via a Cued Speech transliterator. This is because Cochlear Implants have not conquered the obstacles of noise, distance and the speed and amount of information delivered in an academic classroom.

Most of my CI/Cued Speech kids have advanced language, vocabulary and listening abilities. Examples include: a second grader who received the highest score in her grade on a standardised state test in a high-performing elementary school last spring and a first grader who is the best reader in her class.

These examples are outstanding but unusual for deaf children (or any child for that matter). Their success can be attributed to their innate talent and possibly more importantly to the use of Cued Speech with their cochlear implant.'(3)

In England successful case studies include Alexandra who had very delayed language until her parents started to cue. Over the next two years she quickly caught up and prior to the implant her mother wrote that `professionals recognised that her receptive language with Cued Speech appeared to be age appropriate and questions were raised as to whether Alexandra might have become so dependent on this form of communication that she might experience difficulty in adjusting. In fact, the transition from cueing to fully oral communication happened completely smoothly. After as little as three months, the clarity of her speech improved significantly and other people started to understand her. Cued Speech continued to be valuable in language acquisition for some months to come, reinforcing the links between the language she knew visually and the new sounds she was hearing. Even now it is still invaluable in noisy situations, when the implant is not in use and in breaking down the sounds in words which hearing children also find difficult!

`It is now 4« years since we learned how to Cue and 2« years since Alexandra received her Cochlear Implant. Her progress has been everything we could have hoped for. Her reading age and vocabulary are both above her chronological age and her personality has become more settled. Deafness has ceased to be an insurmountable problem. The only regrets we have are that she didn't receive the benefits of Cued Speech and her Cochlear Implant much earlier.'

At Alexandra's 12 month post implant assessment her Teacher of the Deaf wrote: `In my 30 years experience of working with profoundly deaf children, I have never witnessed the remarkable progress that Alexandra and her parents have made throughout this year, following implant. In my opinion, Alexandra is a little girl who is now totally oral/aural, in her ability to develop speech and language and shows listening levels which one would not normally anticipate until at least two or three years of wearing her processor'.

Why is Cued Speech so successful? Hearing people use their knowledge of the sounds of English when they learn to cue. Deaf children brought up with Cued Speech work in the opposite way. They acquire an internal model of sound-based English through Cued Speech - even if they can't hear it. Once the implant gives them access to speech sounds these can be plotted onto the model of sound-based English they have already internalised. Belgian research - and many case studies - demonstrates that children brought up with Cued Speech can think in sound-based language.(4)

It is this visual access to sound-based language that enables a deaf child to acquire an understanding of spoken language without delay pre-implant and also uniquely primes the child for the acquisition of spoken language when it becomes available post implant. As Jane Smith, with her 20 years experience, said: `Cued Speech helps clarify and verify what is heard; it actually accelerates the learning of language and listening'.

By Anne Worsfold with grateful thanks to Maureen Brenton and Pat Cove for their translations of source documents.

For details about cueing in the UK contact:
Cued Speech Association UK
9 Duke Street
Dartmouth Devon
TQ6 9PY

Telephone (voice and text) 01803 832 784
Fax 01803 835 311

Email info@cuedspeech.co.uk

Web Cued Speech for the deaf

References
Study produced by Nadine Cochard, Marie-Noelle Calmels, Geraldine Pavia, Christine Landron, Helene Husson, Anne Honegger, Bernard Fraysse. Text by Nadine Cochard (Paediatric Unit of cochlea implants - CHU/CESDA Toulouse)
MOC website MOC (Método Oral Complementado) or email Prof. Santiago Torres monreal@uma.es.
First published in the magazine of the National Cued Speech Association (USA)
Various research including:
Leybaert, J. & Charlier, B. (1996), `Visual Speech in the Head: The Effect of Cued Speech on Rhyming, Remembering and Spelling. Journal of Deaf Studies and Deaf Education, Vol. 1, pp. 234-248.
M

Cochlear implantation and cued speech internationally

shel90 · 08-07-2007, 10:16 AM

Try to convince those who believe that children with CIs should be in a strictly oral-only environment to adopt this approach.

So many approaches so many tools..

ASL is a language

English is a language

TC is a tool

Signed English is a code

Cued speech is a tool

Sim-Com is a code

What else???

hmmm...how much more complicated can it get for deaf people and children?

Cloggy · 08-08-2007, 02:34 AM

IOML, thanks for the article..

"How can we ensure that implanted children reach their potential? Research and case studies from Europe and America suggest that the early and constant use of Cued Speech by family members and professionals can significantly improve the children's ability to benefit from the implant. "

I can vouch for that. Lotte (and we) benefitted much from the signlanguage that she knew before she got CI.

BTW Shel....
"Try to convince those who believe that children with CIs should be in a strictly oral-only environment to adopt this approach." must be about people you meet in your professional life. I have not encountered them in any messageboard I have visited..

shel90 · 08-08-2007, 06:47 AM

Quote:

Originally Posted by Cloggy

IOML, thanks for the article..

"How can we ensure that implanted children reach their potential? Research and case studies from Europe and America suggest that the early and constant use of Cued Speech by family members and professionals can significantly improve the children's ability to benefit from the implant. "

I can vouch for that. Lotte (and we) benefitted much from the signlanguage that she knew before she got CI.

BTW Shel....
"Try to convince those who believe that children with CIs should be in a strictly oral-only environment to adopt this approach." must be about people you meet in your professional life. I have not encountered them in any messageboard I have visited..

Not u...someone else. Rather not name names. Yes, a few people that I have encountered in my professional life too.

jillio · 08-08-2007, 02:14 PM

Quote:

Originally Posted by loml

Cochlear implantation and cued speech internationally

Here is what I don't get. If you go so far as to admit that children implanted with CI still need visual input to develop language skills, why is it necessary to invent a new method of providing that visual input when you already have one? ASL accomplishes that and provides the benefit of bilingualism at the same time. And deaf of deaf still achieve the highest lieracy rates of all the groups. There is an obvious reason for that.

Cloggy · 08-08-2007, 05:07 PM

Quote:

Originally Posted by jillio

......... And deaf of deaf still achieve the highest lieracy rates of all the groups. There is an obvious reason for that.

OBVIOUS????

Well, would love to read about those statistics.... where did you get that from ??

Any chance on charing some more information ??

R2D2 · 08-08-2007, 06:35 PM

Quote:

Originally Posted by jillio

Here is what I don't get. If you go so far as to admit that children implanted with CI still need visual input to develop language skills, why is it necessary to invent a new method of providing that visual input when you already have one? ASL accomplishes that and provides the benefit of bilingualism at the same time. And deaf of deaf still achieve the highest lieracy rates of all the groups. There is an obvious reason for that.

I can see why deaf of deaf would get such good results. However, with 90% of children being born into hearing families how would the child get sufficient native exposure to ASL (or BSL or Auslan depending on where you live!) in the first critical few years of their lives? Parents are the main transmitters of language in that time and from what I have seen, it has to be fluent language for the child to develop appropriately.

It seems to me that with cued speech, one advantage is that it's very easy and fast for a hearing parent to pick up, whereas with sign language it takes a great deal of commitment and regular immersion to get to a fluent level quickly. It would require a massive shift in lifestyle to achieve it i.e. spending lots of time in a deaf club to allow the child access to native or fluent sign.

What would be your suggestion from a social policy point of view to overcome those practical difficulties when there are givens such as most parents are often busy with work, other kids, find it difficult to transition to a new culture, find it hard to pick up a new language etc. I know you might personally feel that if the parents are not prepared to do all the hard work they are selfish, but a social policy maker has to make decisions based on the givens.

jillio · 08-08-2007, 07:29 PM

Quote:

Originally Posted by Cloggy

OBVIOUS????

Well, would love to read about those statistics.... where did you get that from ??

Any chance on charing some more information ??

There are reams of research and studies that show that deaf of deaf more closely approximate the academic achievement of their hearing peers. And yes, the reason is obvious. No language delays, and deaf of deaf are exposed to signing from birth. That facillitates their learning of English. If you are truly interested in reading these studies in order to expand your knowlege abase, I will be more than happy to provide you with the information on where to locate them. If, however, that was an attempt at sarcasm, I will not bother. Let me know which it is.

jillio · 08-08-2007, 07:35 PM

Quote:

Originally Posted by R2D2

I can see why deaf of deaf would get such good results. However, with 90% of children being born into hearing families how would the child get sufficient native exposure to ASL (or BSL or Auslan depending on where you live!) in the first critical few years of their lives? Parents are the main transmitters of language in that time and from what I have seen, it has to be fluent language for the child to develop appropriately.

It seems to me that with cued speech, one advantage is that it's very easy and fast for a hearing parent to pick up, whereas with sign language it takes a great deal of commitment and regular immersion to get to a fluent level quickly. It would require a massive shift in lifestyle to achieve it i.e. spending lots of time in a deaf club to allow the child access to native or fluent sign.

What would be your suggestion from a social policy point of view to overcome those practical difficulties when there are givens such as most parents are often busy with work, other kids, find it difficult to transition to a new culture, find it hard to pick up a new language etc. I know you might personally feel that if the parents are not prepared to do all the hard work they are selfish, but a social policy maker has to make decisions based on the givens.

Sweden has a wonderful policy that insures that all parents of newly diagnosed children are exposed to Deaf culture and receive instruction in sign...homebound instruction if necessary. And while a parent may not become fluent immediately, they will, if the effort is expended, be able to communicate on the developmental level of a young child, much in the same way that hearing parents alter the way they use oral language with a small hearing child. CS might be easier to learn, but it simply isn't useful for acquisition purposes. And I tend to agree with you. You make the effort to provide your child with the things that will meet that child's needs. If it is difficult, oh, well. That is an obligation you take on when you make the decision to become a parent. Judging from the number of parents that are forced to attend parenting classes in the United States, however, it would appear that a social policy needs to be in place to insure that parents do what should be a given.

R2D2 · 08-09-2007, 12:12 AM

Quote:

Originally Posted by jillio

Sweden has a wonderful policy that insures that all parents of newly diagnosed children are exposed to Deaf culture and receive instruction in sign...homebound instruction if necessary. And while a parent may not become fluent immediately, they will, if the effort is expended, be able to communicate on the developmental level of a young child, much in the same way that hearing parents alter the way they use oral language with a small hearing child. CS might be easier to learn, but it simply isn't useful for acquisition purposes. And I tend to agree with you. You make the effort to provide your child with the things that will meet that child's needs. If it is difficult, oh, well. That is an obligation you take on when you make the decision to become a parent. Judging from the number of parents that are forced to attend parenting classes in the United States, however, it would appear that a social policy needs to be in place to insure that parents do what should be a given.

Sweden is an interesting example isn't it? It is bilingual but also apparently 90% of deaf children there have CIs. I wonder whether the attitude of the deaf community toward child implantation there is more neutral because they know that the learning of sign is mandated by law both for the child and the parents?

shel90 · 08-09-2007, 08:17 AM

Quote:

Originally Posted by R2D2

Sweden is an interesting example isn't it? It is bilingual but also apparently 90% of deaf children there have CIs. I wonder whether the attitude of the deaf community toward child implantation there is more neutral because they know that the learning of sign is mandated by law both for the child and the parents?

I wouldn't be surprised if that's the case cuz the attempt to discredit or eliminate sign language evokes a strong emotional reactions from the Deaf community. I don't think the CIs would be as controversial if this law was mandated here in the USA.

My friend visited there last year. I will try to remember to ask her about the Deaf community there being neutral about CIs.

Cloggy · 08-09-2007, 09:56 AM

Quote:

Originally Posted by jillio

There are reams of research and studies that show that deaf of deaf more closely approximate the academic achievement of their hearing peers. And yes, the reason is obvious. No language delays, and deaf of deaf are exposed to signing from birth. That facillitates their learning of English. If you are truly interested in reading these studies in order to expand your knowlege abase, I will be more than happy to provide you with the information on where to locate them. If, however, that was an attempt at sarcasm, I will not bother. Let me know which it is.

No sarcasm...

Would love to read one of those studies.
Can you start a new thread with it?

jillio · 08-09-2007, 01:08 PM

Quote:

Originally Posted by R2D2

Sweden is an interesting example isn't it? It is bilingual but also apparently 90% of deaf children there have CIs. I wonder whether the attitude of the deaf community toward child implantation there is more neutral because they know that the learning of sign is mandated by law both for the child and the parents?

I think so, because their policy addressses CI as an assistive tool, and not as a way to promote and oral philosophy and assimilation into hearing culture. That is the biggest complaint of the deaf community here in the states. That CI is not used as an assistive devise in recognition of the continuing deaf status of the child.

jillio · 08-09-2007, 01:09 PM

Quote:

Originally Posted by Cloggy

No sarcasm...

Would love to read one of those studies.
Can you start a new thread with it?

Yep.

Cloggy · 08-09-2007, 03:16 PM

Quote:

Originally Posted by jillio

I think so, because their policy addressses CI as an assistive tool, and not as a way to promote and oral philosophy and assimilation into hearing culture. That is the biggest complaint of the deaf community here in the states. That CI is not used as an assistive devise in recognition of the continuing deaf status of the child.

The US-label is self-inflicted.... The "way to promote and oral philosophy and assimilation into hearing culture." is the way the "deaf community here in the states" is wants to see it...

If USA had the same approach as Sweden, deaf community would still look at it from their own angle....
Main difference between Sweden and USA is how healthcare is set up... That makes the difference, and makes it possible for such a high percentage of deaf children with (bi-lateral) CI....
Same for Norway....

Cloggy · 08-09-2007, 03:18 PM

Quote:

Originally Posted by jillio

Yep.

Great,
Can you send me some articles regarding "Deaf of deaf still achieve the highest literacy rates of all the groups. "
A title and the abstract will be fine as well, but the complete article would be great!
Thanks

Cloggy · 08-09-2007, 03:23 PM

Quote:

Originally Posted by jillio

Sweden has a wonderful policy that insures that all parents of newly diagnosed children are exposed to Deaf culture and receive instruction in sign...homebound instruction if necessary.

Correct, like in Norway where learning to communicate with your childe and exposure to other deaf people is stimulated... But still, what percentage still choose for CI for their child????

jillio · 08-11-2007, 10:08 PM

Quote:

Originally Posted by Cloggy

IOML, thanks for the article..

"How can we ensure that implanted children reach their potential? Research and case studies from Europe and America suggest that the early and constant use of Cued Speech by family members and professionals can significantly improve the children's ability to benefit from the implant. "

I can vouch for that. Lotte (and we) benefitted much from the signlanguage that she knew before she got CI.

BTW Shel....
"Try to convince those who believe that children with CIs should be in a strictly oral-only environment to adopt this approach." must be about people you meet in your professional life. I have not encountered them in any messageboard I have visited..

CS is not a signed language.

jillio · 08-11-2007, 10:10 PM

Quote:

Originally Posted by Cloggy

Correct, like in Norway where learning to communicate with your childe and exposure to other deaf people is stimulated... But still, what percentage still choose for CI for their child????

As I have stated num,erous times, cloggy, CI is not the issue. The assumption the a CI will allow a child to function the same way academically and socially as a hearing child is the issue for me. The children who perform best with CI are those exposed to both sign and speech in both their academic and social environments (marshark, et. al. 2005)

jag · 08-12-2007, 03:49 AM

Quote:

Originally Posted by jillio

Here is what I don't get. If you go so far as to admit that children implanted with CI still need visual input to develop language skills, why is it necessary to invent a new method of providing that visual input when you already have one? ASL accomplishes that and provides the benefit of bilingualism at the same time. And deaf of deaf still achieve the highest lieracy rates of all the groups. There is an obvious reason for that.

Cued speech has been around for awhile. My guess is this is the advantage over ASL.

"Why is Cued Speech so successful? Hearing people use their knowledge of the sounds of English when they learn to cue. Deaf children brought up with Cued Speech work in the opposite way. They acquire an internal

08-07-2007, 10:16 AM	#2 (permalink)
shel90 Sun Whorshipper Join Date: Sep 2006 Location: A Desert Rat that has found herself in Maryland Posts: 12,620 Blog Entries: 1	Try to convince those who believe that children with CIs should be in a strictly oral-only environment to adopt this approach. So many approaches so many tools.. ASL is a language English is a language TC is a tool Signed English is a code Cued speech is a tool Sim-Com is a code What else??? hmmm...how much more complicated can it get for deaf people and children? __________________ ~Shel~

08-08-2007, 02:34 AM	#3 (permalink)
Cloggy Gravity Sucks Join Date: Feb 2005 Location: Norway Posts: 3,631 Blog Entries: 5	IOML, thanks for the article.. "How can we ensure that implanted children reach their potential? Research and case studies from Europe and America suggest that the early and constant use of Cued Speech by family members and professionals can significantly improve the children's ability to benefit from the implant. " I can vouch for that. Lotte (and we) benefitted much from the signlanguage that she knew before she got CI. BTW Shel.... "Try to convince those who believe that children with CIs should be in a strictly oral-only environment to adopt this approach." must be about people you meet in your professional life. I have not encountered them in any messageboard I have visited.. __________________ . The limits of my language mean the limits of my world. . . . Ludwig Wittgenstein (1889 - 1951) Information about . . . . . . . . . My daughter . . . . . . . . . How the ear works . . . . . . . . . Nonsense/ Myths about CI, here,or here.

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