Browsing by Subject "cochlear implant"

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    Inferencing Abilities of Deaf College Students: Foundations and Implications for Metaphor Comprehension and Theory of Mind
    (Springer, 2021-04) Edwards, Lindsey; Marschark, Marc; Kronenberger, William G.; Crowe, Kathryn; Walton, Dawn; Psychiatry, School of Medicine
    Understanding nonliteral language requires inferencing ability and is an important but complex aspect of social interaction, involving cognitive (e.g., theory of mind, executive function) as well as language skill, areas in which many deaf individuals struggle. This study examined comprehension of metaphor and sarcasm, assessing the contributions of hearing status, inferencing ability, executive function (verbal short-term/working memory capacity), and deaf individuals’ communication skills (spoken versus signed language, cochlear implant use). Deaf and hearing college students completed a multiple-choice metaphor comprehension task and inferencing tasks that included both social-emotional (i.e., theory of mind) and neutral inferences, as well as short-term memory span and working memory tasks. Results indicated the hearing students to have better comprehension of nonliteral language and the ability to make social-emotional inferences, as well as greater memory capacity. Deaf students evidenced strong relationships among inferential comprehension, communication skills, and memory capacity, with substantial proportions of the variance in understanding of metaphor and sarcasm accounted for by these variables. The results of this study enhance understanding of the language and cognitive skills underlying figurative language comprehension and theory of mind and have implications for the social functioning of deaf individuals.
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    Neurocognitive Risk in Children With Cochlear Implants
    (American Medical Association, 2014-07) Kronenberger, William G.; Beer, Jessica; Castellanos, Irina; Pisoni, David B.; Miyamoto, Richard T.; Psychiatry, School of Medicine
    IMPORTANCE Children who receive a cochlear implant (CI) for early severe to profound sensorineural hearing loss may achieve age-appropriate spoken language skills not possible before implantation. Despite these advances, reduced access to auditory experience may have downstream effects on fundamental neurocognitive processes for some children with CIs. OBJECTIVE To determine the relative risk (RR) of clinically significant executive functioning deficits in children with CIs compared with children with normal hearing (NH). DESIGN, SETTING, AND PARTICIPANTS In this prospective, cross-sectional study, 73 children at a hospital-based clinic who received their CIs before 7 years of age and 78 children with NH, with average to above average mean nonverbal IQ scores, were recruited in 2 age groups: preschool age (age range, 3–5 years) and school age (age range, 7–17 years). No children presented with other developmental, cognitive, or neurologic diagnoses. INTERVENTIONS Parent-reported checklist measures of executive functioning were completed during psychological testing sessions. MAIN OUTCOMES AND MEASURES Estimates of the RR of clinically significant deficits in executive functioning (≥ 1 SDs above the mean) for children with CIs compared with children with NH were obtained based on 2 parent-reported child behavior checklists of everyday problems with executive functioning. RESULTS In most domains of executive functioning, children with CIs were at 2 to 5 times greater risk of clinically significant deficits compared with children with NH. The RRs for preschoolers and school-aged children, respectively, were greatest in the areas of comprehension and conceptual learning (RR [95% CI], 3.56 [1.71–7.43] and 6.25 [2.64–14.77]), factual memory ( 4.88 [1.58–15.07] and 5.47 [2.03–14.77]), attention (3.38 [1.03–11.04] and 3.13 [1.56–6.26]), sequential processing (11.25 [1.55–81.54] and 2.44 [1.24–4.76]), working memory (4.13 [1.30–13.06] and 3.64 [1.61–8.25] for one checklist and 1.77 [0.82–3.83] and 2.78 [1.18–6.51] for another checklist), and novel problem-solving (3.93 [1.50–10.34] and 3.13 [1.46–6.67]). No difference between the CI and NH samples was found for visual-spatial organization (2.63 [0.76–9.03] and 1.04 [0.45–2.40] on one checklist and 2.86 [0.98–8.39] for school-aged children on the other checklist). CONCLUSIONS AND RELEVANCE A large proportion of children with CIs are at risk for clinically significant deficits across multiple domains of executive functioning, a rate averaging 2 to 5 times that of children with NH for most domains. Screening for risk of executive functioning deficits should be a routine part of the clinical evaluation of all children with deafness and CIs.