title: Effects of maternal sensitivity and cognitive and linguistic stimulation on cochlear implant users' language development over four years.
abstract: OBJECTIVE
  To examine the effects of observed maternal sensitivity (MS), cognitive stimulation (CS), and linguistic stimulation on the 4-year growth of oral language in young, deaf children receiving a cochlear implant. Previous studies of cochlear implants have not considered the effects of parental behaviors on language outcomes.
  
  
  METHODS
  In this prospective, multisite study, we evaluated parent-child interactions during structured and unstructured play tasks and their effects on oral language development in 188 deaf children receiving a cochlear implant and 97 normal-hearing children as controls. Parent-child interactions were rated on a 7-point scale using the National Institute of Child Health and Human Development's Early Childcare Study codes, which have well-established psychometric properties. Language was assessed using the MacArthur Bates Communicative Development Inventories, the Reynell Developmental Language Scales, and the Comprehensive Assessment of Spoken Language.
  
  
  RESULTS
  We used mixed longitudinal modeling to test our hypotheses. After accounting for early hearing experience and child and family demographics, MS and CS predicted significant increases in the growth of oral language. Linguistic stimulation was related to language growth only in the context of high MS.
  
  
  CONCLUSIONS
  The magnitude of effects of MS and CS on the growth of language was similar to that found for age at cochlear implantation, suggesting that addressing parenting behaviors is a critical target for early language learning after implantation.
authors.affiliation: Department of Psychology, University of Miami, Miami, FL, USA. aquittner@miami.edu
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Quittner
authors.forename: Ivette
authors.initials: I
authors.lastname: Cruz
authors.forename: David H
authors.initials: DH
authors.lastname: Barker
authors.forename: Emily
authors.initials: E
authors.lastname: Tobey
authors.forename: Laurie S
authors.initials: LS
authors.lastname: Eisenberg
authors.forename: John K
authors.initials: JK
authors.lastname: Niparko
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D003054:Cochlear Implants; D003071:Cognition; D003638:Deafness / Q000628:therapy*; D004644:Emotions; D005260:Female; D006801:Humans; D007804:Language Development; D008037:Linguistics; D008297:Male; D008425:Maternal Behavior / Q000523:psychology*; D009034:Mother-Child Relations; D011446:Prospective Studies; D013997:Time Factors