Use of speech by children from total communication programs who wear cochlear implants

This study examined whether children who are deaf acquire usable speech or continue to rely primarily on manual communication when they are enrolled in a total communication setting following receipt of a cochlear implant. Furthermore, it considered whether the use of speech post-implant is associated with other outcomes such as better speech perception skills, English language competence, speech intelligibility, and educational mainstrearning. Language samples were elicited from twenty-seven 8- and 9-year-olds who had received a Nucleus 22-channel cochlear implant before age 5 and were enrolled in a total communication program for at least the first 3 years following implantation. Samples were transcribed by mode of production (i.e., speech or sign) and scored for lexical diversity, syntax, utterance length, and use of bound morphemes. Results revealed a wide range of mode preference, with some children using primarily speech, some primarily sign, and some using both modes to varying extents. Not only did speech users achieve higher auditory speech perception scores and speech intelligibility ratings, but they also demonstrated better comprehension and use of English syntax than did children who used little or no speech. After 3 years with an implant, speech users were more likely than children who used little or no speech to be placed in mainstream educational programs.