Abstract
PURPOSE: This investigation addressed two main questions: (a) How do toddlers' spoken utterances change during the first year of cochlear implant (CI) use? and (b) How do the time-courses for reaching spoken word milestones after implant activation compare with those reported for typically developing children? These questions were explored to increase understanding of early semantic development in children who receive CIs before their second birthdays. METHODS: Monthly recordings of mother-child interactions were gathered during the first year of CI use by a boy and a girl whose CIs were activated at 11 and 21 months of age, respectively. Child utterances were classified as nonwords, pre-words, single words, or word combinations, and the percentages of these utterance types were calculated for each month. Data were compared to published findings for typically developing children for the number of months of robust hearing (i.e., auditory access to conversational speech) needed to reach spoken word milestones and the chronological ages at which milestones were achieved. RESULTS: The main findings were that the percentages of nonwords and pre-words decreased as single words and word combinations increased. Both children achieved most spoken word milestones with fewer months of robust hearing experience than reported for typically developing children; the youngest recipient achieved more milestones within typical age ranges than the child implanted later in life. CONCLUSIONS: The children's expeditious gains in spoken word development appeared to be facilitated by interactions among their pre-implant hearing experiences; their relatively advanced physical, cognitive, and social maturity; participation in intervention programs; and the introduction of robust hearing within the Utterance Acquisition phase of language development according to the neurolingusitic theory (J. Locke, 1997).