Abstract
The use of cochlear implants in children younger than 3 years of age presents challenges to clinicians who provide communication intervention. This article covers four of these challenges including the developmental appropriateness of materials and procedures with very young children, behavior and compliance issues, the need for less didactic instruction and more incidental learning emphasis, and recognition of the home as the primary venue for language learning. A proposed communication assessment protocol is suggested, which includes the Infant-Toddler Meaningful Auditory Integration Scale, a scale to evaluate meaningful use of sound in everyday situations. A hierarchy of intervention techniques is presented along with specific teaching activities, based upon the skills assessed.
Babies learn most of what they know from interactions with their parents, but not of the formal, instructional variety. Babies learn from spontaneous, everyday events-the mailman at the door with a package to open [horizontal ellipsis] all of which need adult interpretation. They are real events of interest and concern to babies and young children. By contrast, infant education is artificial and out of context. Scarr (1984, p. 27)
THIS ARTICLE covers communication intervention approaches with young children receiving cochlear implants. The reader will note that the author deals exclusively with auditory/oral development, because this represents the methodology overwhelmingly chosen by families of children implanted younger than age 3. Although selection of communication methodology and sign language instruction are beyond the scope of this article, the suggestions contained herein may still be useful for youngsters with implants using a total communication approach.