Research Study on Communicative and Linguistic Abilities of Italian Deaf Children with Early Cochlear Implantation

Project location: ITALY, Rome
Project start date: December 2010 - Project end date: December 2011
Project number: 2010-62
Beneficiary: CNR

The researches carried in the ISTC by the "Neuropsychology of Language and Deafness" Unit, started in the 1980's, investigate the acquisition and use of language as a cognitive process in children and adults, focusing on the different modalities in which it is expressed in typical and atypical populations. The goal is to find the origins and the "universal" aspects of language and the way in which it is linked to the cognitive development in general (and specifically to the symbolic one), to the modality of expression (acoustic-vocal and visual-gestural), to the elementary processes (perception, attention and memory) and to the input. The investigation and the theorization of the multimodal features (acoustic-vocal and visual-gestural), frequent in different languages (sign language, verbal language and written language), are now particularly relevant in the light of the new models developed by neurosciences. Those models underline that there is a deep linkage between sensorial and motor process (involved in the neural structures) and symbolic and linguistic skills, both gestural and vocal ones.

At present time the research in these areas and related topics are carried out by three Laboratories: "Sign Language" (SLL, coordinated by Elena Pizzuto); "Gesture and Language" (GaLL, coordinated by Olga Capirci); "Language Development and Disorders" (DaLL, coordinated by Maria Cristina Caselli).

One of the major objectives pursued by research of "Sign Language" Lab, and by comparative analyses of different signed and spoken languages, is to clarify which role some features of the specific visual-gestural modality play in the production of linguistic structures. The second group of researches, strictly related to the first one, investigates the relationship between actions, manual gestures, vocalizations and words, with the purpose to identify, in a continuum, the progression from non linguistic communication to linguistic communication, both in gestural and vocal modality. The third group of researches, also strongly related to the first two groups, is relative to children acquiring language in periods and modality that are different respect to "typical" children: specific language impaired, deaf, cognitive impaired children. Also in this case, the main purpose is to analyze the linkage between cognition and language and the relations between each linguistic components (e.g. lexicon and grammar), modalities (gestural and vocal), areas (comprehension and production).
All these fields are providing several applicative outcomes. The results of our studies and the goal to test and improve the new knowledge drove us to develop and validate new tests for the evaluation of communication and language for the first childhood, directs both to typical developmental children and to pathological children. This is the reason of a real cooperation with the near health services (ASL) and with different centers for diagnosis and rehabilitation, in order to identify the diagnostic criteria and the modality for supporting and evaluating children.
Particularly, several tests were experimented and, in a lot of cases, adapted for evaluating the cognitive (using non verbal tests), communicative, linguistic (Italian and LIS) and social skills of preschooler deaf children. Those evaluations show that the linguistic skills of children are strongly influenced by the affective-social environment in which children live and by the quality and quantity of educative plans. The evaluation of linguistic abilities in vocal and in LIS showed that the visual-gestural communicative modality seems to support the linguistic acquisitions both in comprehension and production in all the children (also in children of hearing parents).
At the same time we also experimented new speech therapies and educational methodologies directs to deaf children.
These educational models were developed to promote the improvement of linguistic and scholastic learning and an adequate cognitive, emotional and communicative-social development, for a better scholastic integration. Particularly we cooperated with speech therapists and deaf adults in order to elaborate models of bimodal education for speech therapy, and models of bilingual education for school. Collaborating with the kindergarten and the elementary school, that was part of the Istituto Statale dei Sordi (now "173° Circolo didattico dell'ISISS di Roma), we developed, for the first time in Italy, a scholastic model of integration - deaf/hearing children - based on bilingualism Italian/LIS, that involved also the participation of deaf educators. A particular focus of attention was on the experimentation of new computer technologies in the education of deaf children.
The focus on the aspects of evaluation and education of deaf children allow us to provide more information to families, becoming more aware relative to the speech therapy, to school and, recently, to the different methodologies of prosthesis (traditional ones or cochlear implant). This experience became stronger and regularly organized in the activities of "Sportello di informazione e consulenza sulla sordità", started in 2003 in the ISSR, directed to families, schools, operator and every institution or organization interested to the education and training of deaf people.

Children born deaf or who become deaf early in life are at risk for delays in the comprehension and production of spoken language (among others, Caselli, Maragna, & Volterra, 2006; Rinaldi & Caselli, 2009; Spencer & Marschark, 2006). Since the 1990s, the use of cochlear implants (CI) has become increasingly widespread among deaf pre-school children, and studies have suggested that the increased access to sound provided by the CI can help children to develop their skills in communicative and linguistic skills (Connor, Craig, Raudenbush, Heavner, & Zwolan, 2006; Dettman, Pinder, Briggs, Dowell, & Leigh, 2007; Kirk, Miyamoto, Ying, & Perdew, 2002; Svirsky, Su-Wooi, & Neuburger, 2004; Tomblin, Spencer, Flock, Tyler, & Gantz, 1999). However, all studies highlighted the large variations in language skills among children with CIs. These individual differences could potentially be explained by numerous variables, such as age at diagnosis of hearing loss, age at beginning language rehabilitation, and the child's general intellectual skills, demonstrating how the plasticity of the child's brain and basic cognitive competence are crucial for successive learning (Geers, Nicholas, &
Sedey, 2003; Moeller, 2000; Richter, Eissele, Laszig, & Lohle, 2002; Uchanski & Geers, 2003; Yoshinaga-Itano, 2003). Most studies in the literature regard English-speaking children and although they have provided important information, their findings may not be directly applicable to deaf children acquiring other languages.
In Italy, few studies have evaluated the effects of the CI on language acquisition in deaf children, and all of these were case studies or studies on small groups with a very wide age range (Bortolini, Basso, Genovese, & Arslan, 2007; Chilosi, Orazini, Comparini, Moretti, & Cipriani, 2009; De Iaco, Guerzoni, & Trabacca, 2003; Caselli, Rinaldi, Varuzza, Giuliani & Burdo, submitted).
The objectives of the present study will be: i) to evaluate phonological and morpho-syntactic abilities, in both comprehension and production, in Italian children who had received a CI within the third year of life; ii) to study the abilities of children with CI to comprehend a story orally presented; and iii) to compare the language abilities of implanted children with those of control group of hearing pair.

Maria Cristina Caselli (Senior Researcher- Scientific Responsible for the Project)
Virginia Volterra (Research Associated)

Technical Support
Tommaso Lucioli
Stefano Marta

The project received a grant from the Nando Peretti Foundation. It aims to provide new evidence on the role of CI on communicative and linguistic development in children, and to clarify which factors (e.g. age at diagnosis of hearing loss, age at beginning language rehabilitation, type of speech-therapy) could potentially explain the individual differences. Families and operators will be informed about the results of the assessment in order to support and address the educational and rehabilitative process in a more effective way.

Fifteen deaf children with CI will be recruited at Infant Schools or at Italian Health Service; the group of hearing pairs will be recruited at Infant Schools. Children will be individually tested and observed during spontaneous interactions. Parents and/or teachers will be also requested to fill in a questionnaire to asses communicative abilities of children in different contexts. All testing sessions will be videotaped, transcribed and analyzed. Particular attention will be paid to the non-verbal modality eventually used by children (gestures and/or Sign Language) and to the individual developmental profiles. The differences among the groups will be tested using one-way analysis of variance (ANOVA).

The National Council of Researches (CNR) is a national public institution involved in the development, enhancement, divulgation and transfer research activities in the main areas of the development of knowledge and its application in the scientific, technological, economic and social development of the Country.
The Institute of Cognitive Sciences and Technologies (ISTC) is involved in research, enhancement, technological transfer and training activities in the following scientific areas and as far as the following themes are concerned:
• Cognitive, communicative and linguistic processes: acquisition, elaboration, deficit, multimodality, communication technologies.
• Theory, analysis and technology of spoken language and of linguistic variability.
• Cognitive development, learning and socialization in children and non-human primates.
• Artificial intelligence, artificial life, artificial societies.
• Cognitive technologies, neural networks, autonomous robotics.
• Social cognition: behaviour, motivations, cultural transmission and cultural processes.
• Decision-making and cooperation technologies.
• Quality of the environment, health and society: prevention, education, integration, handicap, technological planning
think global, act local
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