title: Using SNAP Dragons to monitor narrative abilities in young deaf children following cochlear implantation.
abstract: OBJECTIVE
  To assess the narrative abilities of young deaf children before cochlear implantation and 1 and 2 years following implantation, and to explore possible changes in the implanted children's preferred mode of communication in the narrative abilities task.
  
  
  METHODS
  Prospective longitudinal study assessing the narrative abilities of young deaf children before and after cochlear implantation.
  
  
  METHODS
  Pediatric tertiary referral center for cochlear implantation.
  
  
  METHODS
  The narrative abilities of 35 young profoundly deaf children were assessed before implantation and 1 and 2 years following implantation using the Stories/Narratives Assessment Procedure. Children with age at implantation less than 6 years were included in the study (mean age at implantation was 3.5 years; range 1.4-5.9 years). All children were filled with the Nucleus multichannel cochlear implant system. With respect to their communication modes, they came from a wide range of backgrounds and all children were encouraged to use their preferred mode of communication during the narrative task.
  
  
  RESULTS
  The data showed that there was a statistically significant increase in narrative abilities across the three data points (P<0.001). Before receiving the implant, children were mostly in the pre-structural, receptive stages and could at most label or comment on the pictures (median narrative stage 2). By the 2-year interval, children were mostly using one or two categories or one complete episode with spontaneous retelling (median narrative stage 4). Although children were not pressured to use any particular communication mode, a shift to speech was found following implantation and this was statistically significant (P<0.001).
  
  
  CONCLUSIONS
  Young implanted deaf children showed a significant progress in their narrative abilities through time and a significant shift in the predominant mode of communication towards more speech orientated communication modes following cochlear implantation.
authors.affiliation: Department of Otolaryngology, Nottingham University Hospital, United Kingdom. thomas.nikolopoulos@nottingham.ac.uk
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Nikolopoulos
authors.forename: Hazel
authors.initials: H
authors.lastname: Lloyd
authors.forename: Helen
authors.initials: H
authors.lastname: Starczewski
authors.forename: Clare
authors.initials: C
authors.lastname: Gallaway
mesh_terms: D001877:Books; D002663:Child Language; D002675:Child, Preschool; D019929:Cochlear Implantation; D003638:Deafness / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D033262:Narration; D011446:Prospective Studies; D013068:Speech Production Measurement; D014705:Verbal Behavior / Q000502:physiology*