scholarly journals Longitudinal Development of Executive Functioning and Spoken Language Skills in Preschool-Aged Children With Cochlear Implants

2020 ◽  
Vol 63 (4) ◽  
pp. 1128-1147 ◽  
Author(s):  
William G. Kronenberger ◽  
Huiping Xu ◽  
David B. Pisoni

Purpose Auditory deprivation has downstream effects on the development of language and executive functioning (EF) in prelingually deaf children with cochlear implants (CIs), but little is known about the very early development of EF during preschool ages in children with CIs. This study investigated the longitudinal development of EF and spoken language skills in samples of children with normal hearing (NH; N = 40) or CIs ( N = 41) during preschool ages. Method Participants were enrolled in the study between ages 3 and 6 years and evaluated annually up to the age of 7 years. Mixed-effects models were used to evaluate and predict growth of spoken language and EF skills over time. Results Children with CIs scored lower than NH peers on language measures but improved significantly over time. On performance-based neurocognitive measures of controlled attention, inhibition, and working memory, children with CIs scored more poorly than the sample of NH peers but comparable to norms, whereas on a parent report behavior checklist, children with CIs scored more poorly than both NH peers and norms on inhibition and working memory. Children with CIs had poorer EF than the sample of NH peers in most domains even after accounting for language effects, and language predicted only the verbal working memory domain of EF. In contrast, EF skills consistently predicted language skills at subsequent visits. Conclusions Findings demonstrate that, despite significant improvement over time, some domains of EF (particularly parent-reported EF) and language skills in children with CIs lag behind those of children with NH during preschool ages. Language delays do not fully explain differences in EF development between children with CIs and NH peers during preschool ages, but EF skills predict subsequent language development in children with CIs.

2017 ◽  
Vol 60 (8) ◽  
pp. 2321-2336 ◽  
Author(s):  
Cynthia R. Hunter ◽  
William G. Kronenberger ◽  
Irina Castellanos ◽  
David B. Pisoni

PurposeWe sought to determine whether speech perception and language skills measured early after cochlear implantation in children who are deaf, and early postimplant growth in speech perception and language skills, predict long-term speech perception, language, and neurocognitive outcomes.MethodThirty-six long-term users of cochlear implants, implanted at an average age of 3.4 years, completed measures of speech perception, language, and executive functioning an average of 14.4 years postimplantation. Speech perception and language skills measured in the 1st and 2nd years postimplantation and open-set word recognition measured in the 3rd and 4th years postimplantation were obtained from a research database in order to assess predictive relations with long-term outcomes.ResultsSpeech perception and language skills at 6 and 18 months postimplantation were correlated with long-term outcomes for language, verbal working memory, and parent-reported executive functioning. Open-set word recognition was correlated with early speech perception and language skills and long-term speech perception and language outcomes. Hierarchical regressions showed that early speech perception and language skills at 6 months postimplantation and growth in these skills from 6 to 18 months both accounted for substantial variance in long-term outcomes for language and verbal working memory that was not explained by conventional demographic and hearing factors.ConclusionSpeech perception and language skills measured very early postimplantation, and early postimplant growth in speech perception and language, may be clinically relevant markers of long-term language and neurocognitive outcomes in users of cochlear implants.Supplemental materialshttps://doi.org/10.23641/asha.5216200


2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Reid Herran ◽  
David Pisoni ◽  
William Kronenberger

Background: Cochlear implants (CIs) restore partial hearing to deaf children, promoting the development of spoken language skills. However, because of reduced auditory and language experience, children who receive CIs are at risk for delays not only in language skills but also in language-related neurocognitive skills such as verbal working memory (VWM - the ability to retain language information in immediate memory concurrently with other cognitive processing). Although VWM delays in children with CIs are well-documented, the foundational processes underlying these delays are less clear. This study investigated the hypotheses that slower speed of information processing during VWM tasks contributes to VWM delays in CI users and that this slower information processing speed is associated with spoken language outcomes.    Methods: 25 early-implanted, prelingually-deaf children with CIs and 25 normal-hearing (NH) peers completed tests of VWM, neurocognitive, and speech-language functioning. Speed of information processing during the VWM test was assessed by measuring response latency and average pause duration.    Results: Children with CIs showed poorer VWM scores than NH peers, but the groups did not differ on response latencies or pause durations. Response latencies were significantly correlated with VWM capacity, speech, and language outcomes in both groups.    Conclusion: Speed of information processing in VWM was similar for children with CIs and NH. In both groups, shorter response latencies (faster speed of execution of the cognitive operations of working memory) were associated with better neurocognitive and spoken language outcomes. In the CI sample, pause durations were inconsistently associated with VWM and language outcomes.    Clinical Policy Impact and Implications: Speed of information processing for VWM is associated with core neurocognitive and spoken language outcomes for children with CIs and should be a routine target of assessment and intervention post-implantation.  


2016 ◽  
Vol 57 ◽  
pp. 112-124 ◽  
Author(s):  
Brigitte E. de Hoog ◽  
Margreet C. Langereis ◽  
Marjolijn van Weerdenburg ◽  
Jos Keuning ◽  
Harry Knoors ◽  
...  

2013 ◽  
Vol 56 (3) ◽  
pp. 805-825 ◽  
Author(s):  
William G. Kronenberger ◽  
David B. Pisoni ◽  
Michael S. Harris ◽  
Helena M. Hoen ◽  
Huiping Xu ◽  
...  

Purpose Verbal short-term memory (STM) and working memory (WM) skills predict speech and language outcomes in children with cochlear implants (CIs) even after conventional demographic, device, and medical factors are taken into account. However, prior research has focused on single end point outcomes as opposed to the longitudinal process of development of verbal STM/WM and speech-language skills. In this study, the authors investigated relations between profiles of verbal STM/WM development and speech-language development over time. Method Profiles of verbal STM/WM development were identified through the use of group-based trajectory analysis of repeated digit span measures over at least a 2-year time period in a sample of 66 children (ages 6–16 years) with CIs. Subjects also completed repeated assessments of speech and language skills during the same time period. Results Clusters representing different patterns of development of verbal STM (digit span forward scores) were related to the growth rate of vocabulary and language comprehension skills over time. Clusters representing different patterns of development of verbal WM (digit span backward scores) were related to the growth rate of vocabulary and spoken word recognition skills over time. Conclusion Different patterns of development of verbal STM/WM capacity predict the dynamic process of development of speech and language skills in this clinical population.


Author(s):  
Daniel R. Romano ◽  
William G. Kronenberger ◽  
Shirley C. Henning ◽  
Caitlin J. Montgomery ◽  
Allison M. Ditmars ◽  
...  

Purpose: Verbal working memory (VWM) delays are commonly found in prelingually deaf youth with cochlear implants (CIs), albeit with considerable interindividual variability. However, little is known about the neurocognitive information-processing mechanisms underlying these delays and how these mechanisms relate to spoken language outcomes. The goal of this study was to use error analysis of the letter–number sequencing (LNS) task to test the hypothesis that VWM delays in CI users are due, in part, to fragile, underspecified phonological representations in short-term memory. Method: Fifty-one CI users aged 7–22 years and 53 normal hearing (NH) peers completed a battery of speech, language, and neurocognitive tests. LNS raw scores and error profiles were compared between samples, and a hierarchical regression model was used to test for associations with measures of speech, language, and hearing. Results: Youth with CIs scored lower on the LNS test than NH peers and committed a significantly higher number of errors involving phonological confusions (recalling an incorrect letter/digit in place of a phonologically similar one). More phonological errors were associated with poorer performance on measures of nonword repetition and following spoken directions but not with hearing quality. Conclusions: Study findings support the hypothesis that poorer VWM in deaf children with CIs is due, in part, to fragile, underspecified phonological representations in short-term/working memory, which underlie spoken language delays. Programs aimed at strengthening phonological representations may improve VWM and spoken language outcomes in CI users.


Author(s):  
William G. Kronenberger ◽  
David B. Pisoni

Cochlear implantation restores some attributes of hearing and spoken language to prelingually deaf children. However, reduced access to auditory and spoken-language experiences for children with cochlear implants can alter the development of downstream neurocognitive functions such as sequential processing and self-regulatory language skills, which are critical building blocks for executive functioning. Executive functioning is the active regulation of cognitive, behavioral, and emotional processes in the service of planned, organized, controlled, goal-driven behavior. This chapter presents findings from two primary lines of research on the development of executive functioning in prelingually deaf, early implanted children with cochlear implants. The first is identification of specific executive function domains that are at risk for delay in children with cochlear implants compared to hearing children. The second is reciprocal influences of executive function and spoken-language skills throughout development in children and adolescents with cochlear implants.


2013 ◽  
Vol 34 (11) ◽  
pp. 3833-3846 ◽  
Author(s):  
Tinne Boons ◽  
Leo De Raeve ◽  
Margreet Langereis ◽  
Louis Peeraer ◽  
Jan Wouters ◽  
...  

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