title: Developmental effects of family environment on outcomes in pediatric cochlear implant recipients.
abstract: OBJECTIVE
  To examine and compare the family environment of preschool- and school-age children with cochlear implants and assess its influence on children's executive function and spoken language skills.
  
  
  METHODS
  Retrospective between-subjects design.
  
  
  METHODS
  Outpatient research laboratory.
  
  
  METHODS
  Prelingually deaf children with cochlear implants and no additional disabilities and their families.
  
  
  METHODS
  Cochlear implantation and speech-language therapy.
  
  
  METHODS
  Parents completed the Family Environment Scale and the Behavior Rating Inventory of Executive Function (or the preschool version). Children were tested using the Peabody Picture Vocabulary Test-4 and either the Preschool Language Scales-4 or the Clinical Evaluation of Language Fundamentals-4.
  
  
  RESULTS
  The family environments of children with cochlear implants differed from normative data obtained from hearing children, but average scores were within 1 standard deviation of norms on all subscales. Families of school-age children reported higher levels of control than those of preschool-age children. Preschool-age children had fewer problems with emotional control when families reported higher levels of support and lower levels of conflict. School-age children had fewer problems with inhibition but more problems with shifting of attention when families reported lower levels of conflict. School-age children's receptive vocabularies were enhanced by families with lower levels of control and higher levels of organization.
  
  
  CONCLUSIONS
  Family environment and its relation to language skills and executive function development differed across the age groups in this sample of children with cochlear implants. Because family dynamics is one developmental/environmental factor that can be altered with therapy and education, the present results have important clinical implications for family-based interventions for deaf children with cochlear implants.
authors.affiliation: Department of Speech and Hearing Sciences, Indiana University, Bloomington, Indiana 47405, USA. raholt@indiana.edu
authors.forename: Rachael Frush
authors.initials: RF
authors.lastname: Holt
authors.forename: Jessica
authors.initials: J
authors.lastname: Beer
authors.forename: William G
authors.initials: WG
authors.lastname: Kronenberger
authors.forename: David B
authors.initials: DB
authors.lastname: Pisoni
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000523:psychology*; D003054:Cochlear Implants; D003638:Deafness / Q000523:psychology / Q000601:surgery*; D004522:Educational Status; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D007804:Language Development; D008297:Male; D019986:Persons with Hearing Disabilities / Q000523:psychology; D012931:Social Environment; D013067:Speech Perception / Q000502:physiology; D016896:Treatment Outcome