As a practitioner dedicated to improving outcomes for children with cochlear implants (CIs), leveraging research-based strategies is paramount. The article "12 guiding premises of pediatric cochlear implant habilitation" by Amy McConkey Robbins provides invaluable insights that can elevate your practice. Here, we distill the key premises to help you implement these findings effectively.
1. Attaching Meaning to Sound
The first premise emphasizes that children must learn to attach meaning to the sounds they hear through their CIs. This requires:
- Auditory access to the language code (vowels, consonants, suprasegmental patterns)
- A nurturing auditory and spoken language environment
- Parental involvement and cognitive development
2. Communicative Competence
The ultimate goal is communicative competence, meaning the child can understand and use human communication at an age-appropriate level. This may include:
- Oral communication
- Sign language or cued speech for receptive clarification
3. Generalization of Skills
Skills learned in therapy must generalize to the child's everyday environments, such as home and school. This can be achieved through:
- Parent involvement as primary agents of development
- Communication notebooks for home-school information sharing
4. Integrated Habilitation Goals
Habilitation should integrate speech, language, perception, and pragmatics within a social/emotional context. A hybrid approach that balances structured practice with naturalistic interactions is recommended.
5. Parental Influence
Parents are the most potent influence on their child's progress. Clinicians should guide parents to be key facilitators of communication development, leveraging everyday interactions.
6. Didactic Instruction and Incidental Learning
Children with CIs benefit from a combination of didactic instruction and incidental learning. Structured training helps maximize auditory potential, especially for older children or those with prior auditory deprivation.
7. Diagnostic Teaching Approach
A diagnostic teaching approach, which adapts to the child's performance and continuously challenges them, yields the most benefit. This method requires flexibility and creativity from clinicians.
8. Educational Content Integration
Using content from the child's educational program in habilitation activities reinforces learning and builds connections between different settings. This approach also fosters collaboration with classroom teachers.
9. Integration of Music
Music supports listening and spoken language development and should be integrated into habilitation. It enhances articulation, language development, and social skills.
10. Unique Approach for Infants and Toddlers
Habilitation for infants and toddlers should focus on guiding parents to be the primary language teachers, emphasizing joint attention and affective state sharing.
11. Monitoring Progress with Auditory Milestones
Established auditory milestones can "red flag" children who are progressing slower than expected, allowing for early intervention and problem identification.
12. Comprehensive Assessment
While formal assessments are important, they may not fully capture a child's communicative competence. Supplement standardized tests with informal procedures and spontaneous language samples for a complete picture.
Conclusion
Implementing these 12 guiding premises can significantly enhance the outcomes for children with cochlear implants. Continual learning and adaptation to new research will ensure even more effective habilitation.To read the original research paper, please follow this link:
12 guiding premises of pediatric cochlear implant habilitation.
