Deaf children with cochlear implants (CIs) represent an intriguing opportunity to study neurocognitive plasticity and reorganization when sound is introduced following a period of auditory deprivation early in development. Although it is common to consider deafness as affecting hearing alone, it may be the case that auditory deprivation leads to more global changes in neurocognitive function. In this paper, we investigate implicit sequence learning abilities in deaf children with CIs using a novel task that measured learning through improvement to immediate serial recall for statistically-consistent visual sequences. The results demonstrated two key findings. First, the deaf children with CIs showed disturbances in their visual sequence learning abilities relative to the typically-developing normal-hearing children. Second, sequence learning was significantly correlated with a standardized measure of language outcome in the CI children. These findings suggest that a period of auditory deprivation has secondary effects related to general sequencing deficits, and that disturbances in sequence learning may at least partially explain why some deaf children still struggle with language following cochlear implantation. Keywordsimplicit sequence learning; deafness; cochlear implants; language development Deaf children with cochlear implants (CIs) provide a unique opportunity to study brain plasticity and neural reorganization. In some sense, this research effort can be thought of as the modern equivalent of the so-called "forbidden experiment" in the field of language development: it provides an ethical research opportunity to study the effects of the introduction of sound and spoken language on cognitive and linguistic development after a period of auditory deprivation. Whereas most previous work with this population has investigated the development of auditory perception, speech perception, and spoken language development, relatively few studies have examined more global learning and cognitive capabilities.There is in fact some indication that a period of auditory deprivation occurring early in development may have secondary cognitive and neural ramifications in addition to the Correspondence concerning this article should be addressed to Christopher M. Conway, Department of Psychology, 3511 Laclede Ave., Saint Louis University, St. Louis, MO 63103. cconway6@slu.edu. NIH Public Access Author ManuscriptDev Sci. Author manuscript; available in PMC 2012 January 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript obvious hearing-related effects. Specifically, because sound by its very nature is a temporally-arrayed signal, a lack of experience with sound may affect how well one is able to encode, process, and learn serial patterns in any modality (Marschark, 2006;Rileigh & Odom, 1972;Todman & Seedhouse, 1994). Exposure to sound may provide a kind of "auditory scaffolding" in which a child gains vital experience and practice with learning and representing sequential patterns in the enviro...
Abstract.A large body of clinical research over the last decade demonstrates that cochlear implants work and provide significant speech and language benefits to profoundly deaf adults and prelingually deaf children. The most challenging research problem today is that cochlear implants do not work equally well for everyone who has a profound hearing loss and cochlear implants frequently do not provide much benefit at all under highly degraded listening conditions. Some individuals do extremely well on traditional audiologic outcome measures with their cochlear implants when tested under benign listening conditions in the clinic and research laboratory while others have much more difficulty. However, all patients with cochlear implants uniformly have difficulty in a number of challenging perceptual domains such as: listening in noise, talking on the telephone, localizing sounds, recognizing familiar voices and different dialects, identifying environmental sounds and listening to music. The enormous variability in outcome and benefit following implantation is not surprising because none of the current generation of cochlear implants successfully restores normal hearing or supports robust speech perception and spoken language processing across all of these difficult and highly variable listening conditions. The traditional outcome measures of audiologic benefit were never designed to assess, understand or explain individual differences in speech perception and spoken language processing. In this chapter, we summarize recent findings that suggest several promising new directions for understanding and explaining variability in outcome and benefit after implantation. These results have implications for the design of new cochlear implants as well as the development of radically new approaches to intervention, training and habilitation following implantation.
We assessed profoundly deaf children with cochlear implants (CIs) (N = 24) and age-matched normal-hearing children (N = 31) on several nonverbal cognition measures: motor sequencing, tactile discrimination, response inhibition, visual-motor integration, and visual-spatial processing. The results revealed that the children with CIs showed disturbances solely on motor sequencing and that performance on this task was significantly correlated with scores on the Clinical Evaluation of Language Fundamentals, 4th Edition (CELF–4). These findings suggest that a period of auditory deprivation before cochlear implantation affects motor sequencing skills, which in turn may mediate the language delays displayed by some deaf children with CIs.
Spoken language consists of a complex, sequentially arrayed signal that contains patterns that can be described in terms of statistical relations among language units. Previous research has suggested that a domain-general ability to learn structured sequential patterns may underlie language acquisition. To test this prediction, we examined the extent to which implicit sequence learning of probabilistically structured patterns in hearing adults is correlated with a spoken sentence perception task under degraded listening conditions. Performance on the sentence perception task was found to be correlated with implicit sequence learning, but only when the sequences were composed of stimuli that were easy to encode verbally. Implicit learning of phonological sequences thus appears to underlie spoken language processing and may indicate a hitherto unexplored cognitive factor that may account for the enormous variability in language outcomes in deaf children with cochlear implants. The present findings highlight the importance of investigating individual differences in specific cognitive abilities as a way to understand and explain language in deaf learners and, in particular, variability in language outcomes following cochlear implantation.
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