1. Patricia Gates Ulanet, PsyD; Nancy Mellon, MS; Christine Carson, ScM*;
Lacey Meenaghan, CCC-SLP; Jessie Walsh, MA;
Amanda Hopkins, CCC-SLP; Meredith Ouellette, CCC-SLP
The River School, Washington DC
*Bloomberg School of Public Heath, Johns Hopkins University, Baltimore, Md
ACHIEVING DEVELOPMENTAL SYNCHRONY IN CHILDREN WITH COCHLEAR IMPLANTS: SOCIAL OUTCOMES
Background:
Children with cochlear implants (CIs) in The River School’s inclusive educational model have reliably overcome significant language delays, achieving language commensurate with hearing peers; however, consistent with the literature, these same children exhibit notable delays in social emotional development (Peterson, 2004) and differences in theory of mind development (Remmel & Peters 2008), thus impacting reciprocal social interactions. A signature intervention program, Accommodating Classroom and Curricula for Social Emotional Learning (ACCSEL) was developed and implemented to target social communication, perspective taking, mental state language, and reciprocal social interactions (RSI). We hypothesized that subjects would demonstrate age-appropriate skills in speech, language, and social interaction following 3 years of intervention.
The Four Parameters of ACCSEL
(ACCOMODATING CLASSROOM AND CURRICULA FOR SOCIAL EMOTIONAL LEARNING)
Theory of Mind:
Reciprocal Social Interactions:
Theory of Mind
Perspective Taking
Reciprocal Social Interactions
Mental State Language
Refers to the ability to infer others’ mental states, thoughts, beliefs, and intentions to predict others’ actions.
Characterized by eye-gaze, response to name, joint attention, and shared affect.
Perspective-taking:
Mental State Language:
Use of language that describes what and how another thinks and feels.
The process of learning to perceive from another’s vantage point.
Methods:
Baseline and 3-year longitudinal data collected on:
RSI (Autism Diagnostic Observation Scale),
IQ (Leiter International Performance, Mullen Scales of Early Learning),
Speech and language (Preschool Language Scale, and CASL).
Subjects:
Year 1: S=9
Baseline age: (m=23) months
Implant age: (m=13) months
Deaf children of Deaf parents (DoD): (n=1)
Year 2: S=3
Baseline age: (m=28) months
Implant age: (m=17) months
DoD: (n=1)
Year 3: S=7
Third year data on first subject group.
Lost to attrition (n=3), including DoD subjects from years 1 and 2.
Year 1 Cognition and Language (N=9)
DoD N=1 (Subject #6)
References
Carrow-Woolfolk, E. (1999). Comprehensive Assessment of Spoken Language. Bloomington, MN:Pearson Assessments.
Lord, C., Risi, S., Lambrecht, L., Cook, E. Jr.H., Leventhal, B.L., DiLavore, P.C., et al. (2000). The Autism Diagnostic Observation Schedule- Generic: A Standard Measure of Social and Communication Deficits Associated with the Spectrum of Autism. Journal of Autism and Developmental Disorders, 30. Los Angeles: Western Psychological Services
Mullen, E. M. (1995). Mullen Scales of Early Learning (AGS ed.). Circle Pines, MN: American Guidance Service Inc.
Peterson, C. C. (2004). Theory of mind in oral deaf children with cochlear implants or conventional hearing aids. Journal of Psychology and Psychiatry 45:6, pp
Remmel. E., and Peters, K. (2008). Theory of mind in children with cochlear implants. Journal of Deaf Studies and Deaf Education Advance Access, pp
Roid, G.H. and Miller, L.J. (1997). Leiter International Performance Scale-Revised. Examiners Manual. Wood Dale, Il: Stoelting Co.
Zimmerman, I.L., Steiner, V.G., & Pond, R.E. (1992) PLS-3: Preschool Language Scale-3. San Antonio, TX: The Psychological Corporation. px
Photo: Mark Thiessen
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More information about The River School can be obtained at
A PDF of this poster is available at:
DEV Synch Poster.pdf
Special thanks to Rob Rock for his technical support.
Year 1: Autism Diagnostic Observation Scale (ADOS)
Results:
Year 1: Despite average nonverbal IQ’s and language development commensurate with hearing age, atypical RSI in 8 of 9 subjects as documented by ADOS scores >7. DoD subject (#6)demonstrated typical RSI.
Year 2: Three new subjects. Two subjects demonstrated atypical RSI. DoD subject demonstrated typical RSI.
Year 3: Total lost to attrition over three years (n=3). Significant improvement compared to Year 1 on RSI scores (p=.0036) and language scores (p=.0050) on average, across 7 remaining Year 1 subjects.
Discussion:
Year 1: Baseline data indicates that despite average non-verbal IQ’s and language commensurate with hearing age, young CI users with hearing caregivers demonstrated early atypical reciprocal social interactions (RSI), while Deaf children of Deaf parents (DoD) subjects (n=2) who shared a common communication mode demonstrated typically developing RSI.
Year 2: Results from Year 1 replicated, suggesting that lack of early exposure to bi-directional communication with caregivers who share a common communication mode negatively impacts early social development.
By Year 3: Following exposure to the embedded ACCSEL curriculum, remaining subjects showed statically significant gains (p=0.0036) in the skills and behaviors associated with typically developing RSI. These findings suggest that targeted early intervention can mitigate social deficits in children with cochlear implants. Longitudinal data collection continues on Groups 2 , 3, and 4.
Trajectory of RSI and Language Development from Yr 1 to Yr 3:
Subjects (n=7) represented by colors.
Lower scores in RSI indicate more positive behavioral outcome.