This study characterized the profile of pragmatic abilities among 24 children with hearing loss (HL) aged 6.3-9.4 years, 13 using hearing aids (HAs) and 11 using cochlear implants (CIs), in comparison to those of 13 hearing children with similar chronological and language ages. All the children with HL used spoken language, attended regular schools, and received communication therapy twice a week. They had no disabilities other than the HL. We assessed pragmatic abilities using the pragmatic protocol of C. A. Prutting & D. M. Kirchner (1987. A clinical appraisal of the pragmatic aspects of language. Journal of Speech and Hearing Disorders, 52, 105-119), which includes verbal, nonverbal, and paralinguistic aspects. Findings showed that children with HL used varied pragmatic functions but revealed more incidents of inappropriate use of the different abilities, compared to hearing children. Intergroup differences were significant only for verbal parameters. No differences emerged between children who used CIs vs. HAs. It seems that the CI group had the same pragmatic abilities as severe HA children. The different or less effective pragmatic abilities of children with HL may be explained by less flexible use of language structures, difficulties in theory of mind, difficulties in auditory perception of spoken language, and less exposure to varied pragmatic situations and strategies. Results indicated the need to incorporate pragmatic communication abilities into rehabilitation programs.

This study evaluated the benefits of cochlear implant (CI) with regard to emotion perception of participants differing in their age of implantation, in comparison to hearing aid users and adolescents with normal hearing (NH). Emotion perception was examined by having the participants identify happiness, anger, surprise, sadness, fear, and disgust. The emotional content was placed upon the same neutral sentence. The stimuli were presented in auditory, visual, and combined auditory-visual modes. The results revealed better auditory identification by the participants with NH in comparison to all groups of participants with hearing loss (HL). No differences were found among the groups with HL in each of the 3 modes. Although auditory-visual perception was better than visual-only perception for the participants with NH, no such differentiation was found among the participants with HL. The results question the efficiency of some currently used CIs in providing the acoustic cues required to identify the speaker's emotional state.

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This study assessed perception of suprasegmental features of speech by 30 prelingual children with sensorineural hearing loss. Ten children had cochlear implants (CIs), and 20 children wore hearing aids (HA): 10 with severe hearing loss and 10 with profound hearing loss. Perception of intonation, syllable stress, word emphasis, and word pattern was assessed. Results revealed that the two HA groups significantly outperformed the CI group in perceiving both intonation and stress. Within each group, word pattern was perceived best, and then intonation and emphasis, with syllable stress perceived poorest. No significant correlation emerged between age at implantation and perception of the various suprasegmental features, possibly due to participants' relatively late age at implantation. Results indicated that CI use did not show an advantage over HA use in the perception of suprasegmental features of speech. Future research should continue to explore variables that might improve this perception.

Emotion understanding and theory of mind (ToM) are two major aspects of social cognition in which deaf children demonstrate developmental delays. The current study investigated these social cognition aspects in two subgroups of deaf children-those with cochlear implants who communicate orally (speakers) and those who communicate primarily using sign language (signers)-in comparison to hearing children. Participants were 53 Israeli kindergartners-20 speakers, 10 signers, and 23 hearing children. Tests included four emotion identification and understanding tasks and one false belief task (ToM). Results revealed similarities among all children's emotion labeling and affective perspective taking abilities, similarities between speakers and hearing children in false beliefs and in understanding emotions in typical contexts, and lower performance of signers on the latter three tasks. Adapting educational experiences to the unique characteristics and needs of speakers and signers is recommended.

The relatively high accuracy of emotion perception by children with HL may be explained by their intensive rehabilitation, which emphasizes suprasegmental and paralinguistic aspects of verbal communication.

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This study examined stress, attitudes, and expectations among mothers of deaf children who underwent cochlear implantation (CI), as related to time elapsed since surgery. Participants were 64 mothers of such children at different points in the implantation process: candidates, 0-3 years postimplantation, and more than 3 years later. Expectations in communication and academic domains decreased as time since implantation passed. No differences emerged in stress levels between the 3 groups. Higher levels of mothers' and fathers' education correlated with lower stress levels. Older mothers expressed lower levels on the cohesion dimension of family functioning. Findings suggested the need to consider mothers' expectations in the rehabilitation process and to encourage mothers' realistic expectations with regard to the effects of CI.