Sentence comprehension and production in children with cochlear implants: Errorless procedures and equivalence-based instruction

Research supports equivalence-based instruction (EBI) and matrix training for increased listening and speaking skills in children with cochlear implants (CI). We incorporated errorless procedures to optimize the EBI and evaluated the effects on the auditory comprehension and verbal responding at-sentences level in six CI children who were readers and showed inaccurate tacting. Subject-verb-object sentences were arranged in two matrices; diagonal combinations were trained and evaluated non-diagonal combinations. EBI included stimulus fading and exclusion to directly teach the dictated sentence-picture matching; written-sentences construction upon dictation also was taught. Probes assessed the derived stimulus-stimulus and stimulus-response relations. All participants learned the auditory-visual discriminations and the exclusion resulted in fewer errors than on a stimulus fading procedure. Five participants formed equivalence classes and increased verbal responding to equivalent stimuli, especially pictures tacting. They also showed recombinative generalization for both matrices. Professionals can incorporate errorless procedures to EBI for improving sentence comprehension, tacting, and productivity in CI children.     

The use of matrix training to promote generative language with children with autism

Matrix training consists of planning instruction by arranging components of desired skills across 2 axes. After training with diagonal targets that each combine 2 unique skill components, responses to nondiagonal targets, consisting of novel combinations of the components, may emerge. A multiple‐probe design across participants was used to evaluate matrix training with known nouns (e.g., cat) and verbs (e.g., jumping) with 5 children with autism spectrum disorders (ASD). Following baseline of Matrix 1 and a generalization matrix, diagonal targets within Matrix 1 were trained as noun–verb combinations (e.g., cat jumping). Posttests showed recombinative generalization within Matrix 1 and the generalization matrix for 4 participants. For 1 participant, diagonal training across multiple matrices was provided until correct responding was observed in the generalization matrix. Results support the use of matrix training to promote untrained responses for learners with ASD and offer a systematic way to evaluate the extent of generalization within and across matrices.     

Relational learning in children with deafness and cochlear implants

This four-experiment series sought to evaluate the potential of children with neurosensory deafness and cochlear implants to exhibit auditory-visual and visual-visual stimulus equivalence relations within a matching-to-sample format. Twelve children who became deaf prior to acquiring language (prelingual) and four who became deaf afterwards (postlingual) were studied. All children learned auditory-visual conditional discriminations and nearly all showed emergent equivalence relations. Naming tests, conducted with a subset of the children, showed no consistent relationship to the equivalence-test outcomes. This study makes several contributions to the literature on stimulus equivalence. First, it demonstrates that both pre- and postlingually deaf children can acquire auditory-visual equivalence relations after cochlear implantation, thus demonstrating symbolic functioning. Second, it directs attention to a population that may be especially interesting for researchers seeking to analyze the relationship between speaker and listener repertoires. Third, it demonstrates the feasibility of conducting experimental studies of stimulus control processes within the limitations of a hospital, which these children must visit routinely for the maintenance of their cochlear implants.     

Generative time telling in adults with disabilities: A matrix training approach

Matrix training is a teaching strategy designed to facilitate generative responding through a process termed recombinative generalization. A skill that has yet to be addressed with matrix training is tacting time increments. Given the two‐component features of time telling (i.e., hours and minutes) and the numerous teaching targets, matrix training was implemented for such behavior with two adults with developmental disabilities. This study used a 12 × 12 matrix that consisted of 144 time increments. Participants were taught 12 time increments, and probes were conducted to assess the remaining 132 untrained time increments. The participants responded correctly to approximately 50% of the untrained time increments during the post‐assessment phase. Limitations and future research are discussed.     

An evaluation of matrix training to teach college students piano notes and rhythms

Twelve college students learned to tact the names of notes and rhythms and play them when presented with compound stimuli (visuals of notes and rhythms on a musical staff). In Experiment 1, we assessed generalization by presenting novel notes, rhythms, and compound stimuli not previously paired together. In the second experiment, we added a metronome that played at 60 beats per minute in all conditions for 3 out of 6 participants to ensure consistent tempo. Across both experiments, participants passed almost all posttests with the exception of tacting and playing in the presence of sound clips. Our data suggest that matrix training is an effective procedure to teach music skills to college students.     

Matrix training of preliteracy skills with preschoolers with autism

Matrix training is a generative approach to instruction in which words are arranged in a matrix so that some multiword phrases are taught and others emerge without direct teaching. We taught 4 preschoolers with autism to follow instructions to perform action-picture combinations (e.g., circle the pepper, underline the deer). Each matrix contained 6 actions on 1 axis and 6 pictures on the other axis. We used most-to-least prompting to train the instructions along the diagonal of each matrix and probed the untrained combinations. For 2 participants, untrained responding emerged after the minimum amount of training. The other 2 participants required further training before untrained combinations emerged. At the end of the study, 3 of the 4 participants performed the trained actions with previously known pictures, letters, and numbers. This study demonstrated that matrix training is an efficient approach to teaching language and literacy skills to children with autism.     

The mathematical abilities of children with cochlear implants

Research has shown that cochlear implants give rise to improvements in speech recognition and production in children with profound hearing loss but very few studies have explored mathematical abilities in these children. The current study compared the mathematical abilities of 24 children with cochlear implants (mean age 10 years 1 month) to a control group of 22 hearing children (mean age 9 years 8 months). The math questions were categorized into questions that tapped into arithmetic or geometrical reasoning. It was predicted that the cochlear implant group would perform below the hearing group on the arithmetic questions but not the geometrical reasoning questions. Unexpectedly, the results showed that the cochlear implant group performed significantly below the hearing group on both types of math questions, but that this difference was mediated by language skill as assessed by vocabulary knowledge. The clinical implications of these results and possible future research results are considered.     

Role of speechreading in audiovisual interactions during the recovery of speech comprehension in deaf adults with cochlear implants

Speechreading is an important form of communicative activity that improves social adaptation in deaf adults. Cochlear implantation allows interaction between the visual speechreading abilities developed during deafness and the auditory sensory experiences acquired through use of the cochlear implant. Crude auditory information provided by the implant is analyzed in parallel with conjectural information from speechreading, thus creating new profiles of audiovisual integration with implications for brain plasticity. Understanding the peculiarities of change in speechreading after cochlear implantation may improve our understanding of brain plasticity and provide useful information for functional rehabilitation of implanted patients. In this article, we present a generalized review of our recent studies and indicate perspectives for further research in this domain.     

Using a multi‐feature paradigm to measure mismatch responses to minimal sound contrasts in children with cochlear implants and hearing aids

Our aim was to explore whether a multi‐feature paradigm (Optimum‐1) for eliciting mismatch negativity (MMN) would objectively capture difficulties in perceiving small sound contrasts in children with hearing impairment (HI) listening through their hearing aids (HAs) and/or cochlear implants (CIs). Children aged 5–7 years with HAs, CIs and children with normal hearing (NH) were tested in a free‐field setting using a multi‐feature paradigm with deviations in pitch, intensity, gap, duration, and location. There were significant mismatch responses across all subjects that were positive (p‐MMR) for the gap and pitch deviants (F(1,43) = 5.17, p = 0.028 and F(1,43) = 6.56, p = 0.014, respectively) and negative (MMN) for the duration deviant (F(1,43) = 4.74, p = 0.035). Only the intensity deviant showed a significant group interaction with MMN in the HA group and p‐MMR in the CI group (F(2,43) = 3.40, p = 0.043). The p‐MMR correlated negatively with age, with the strongest correlation in the NH subjects. In the CI group, the late discriminative negativity (LDN) was replaced by a late positivity with a significant group interaction for the location deviant. Children with severe HI can be assessed through their hearing device with a fast multi‐feature paradigm. For further studies a multi‐feature paradigm including more complex speech sounds may better capture variation in auditory processing in these children.     

Speech timing and working memory in profoundly deaf children after cochlear implantation

Thirty-seven profoundly deaf children between 8- and 9-years-old with cochlear implants and a comparison group of normal-hearing children were studied to measure speaking rates, digit spans, and speech timing during digit span recall. The deaf children displayed longer sentence durations and pauses during recall and shorter digit spans compared to the normal-hearing children. Articulation rates, measured from sentence durations, were strongly correlated with immediate memory span in both normal-hearing and deaf children, indicating that both slower subvocal rehearsal and scanning processes may be factors that contribute to the deaf children's shorter digit spans. These findings demonstrate that subvocal verbal rehearsal speed and memory scanning processes are not only dependent on chronological age as suggested in earlier research by. Instead, in this clinical population the absence of early auditory experience and phonological processing activities before implantation appears to produce measurable effects on the working memory processes that rely on verbal rehearsal and serial scanning of phonological information in short-term memory.     

Sad and happy emotion discrimination in music by children with cochlear implants

Children using cochlear implants (CIs) develop speech perception but have difficulty perceiving complex acoustic signals. Mode and tempo are the two components used to recognize emotion in music. Based on CI limitations, we hypothesized children using CIs would have impaired perception of mode cues relative to their normal hearing peers and would rely more heavily on tempo cues to distinguish happy from sad music. Study participants were children with 13 right CIs and 3 left CIs (M = 12.7, SD = 2.6 years) and 16 normal hearing peers. Participants judged 96 brief piano excerpts from the classical genre as happy or sad in a forced-choice task. Music was randomly presented with alterations of transposed mode, tempo, or both. When music was presented in original form, children using CIs discriminated between happy and sad music with accuracy well above chance levels (87.5%) but significantly below those with normal hearing (98%). The CI group primarily used tempo cues, whereas normal hearing children relied more on mode cues. Transposing both mode and tempo cues in the same musical excerpt obliterated cues to emotion for both groups. Children using CIs showed significantly slower response times across all conditions. Children using CIs use tempo cues to discriminate happy versus sad music reflecting a very different hearing strategy than their normal hearing peers. Slower reaction times by children using CIs indicate that they found the task more difficult and support the possibility that they require different strategies to process emotion in music than normal.     

Effects of exemplar training in exclusion responding on auditory-visual discrimination tasks with children with autism

In Experiment 1 with 7 autistic children (3 to 6 years old), auditory-visual exclusion was tested with four unknown word-item pairs for each child. One child demonstrated exclusion and positive learning outcomes unequivocally with the four auditory-visual relations. Three children demonstrated exclusion, though inconsistently, and failed to demonstrate positive learning outcomes. The remaining 3 children failed to demonstrate exclusion; therefore, the learning outcome test was omitted. The 6 children who failed to demonstrate exclusion or positive learning outcomes participated in the second experiment. In Experiment 2, nonreinforced exclusion trials with four new unknown word-item pairs were included in trial blocks that also contained reinforced exclusion trials with the unknown exemplars from Experiment 1. Five children demonstrated exclusion with the new word-item pairs, and 4 of these demonstrated positive learning outcomes in further tests. One child demonstrated some limited but inconsistent improvement in exclusion and was not tested for learning outcomes. The data suggest that contemporaneous presentation of multiple examples of reinforced exclusion facilitated nonreinforced exclusion performances and that the resulting reduction in errors was critical in producing accurate learning outcomes with the new word-item discriminations.     

Perspectives on multisensory experience and cognitive development in infants with cochlear implants

Infants learn about their environment through sensory exploration, acquiring knowledge that is important for cognitive development. However, little is known about the sensory exploration of infants with profound hearing loss before or after they receive cochlear implants. This paper reviews aspects of sensory perception and cognitive development in hearing infants, discusses the implications of delayed access to auditory information for multisensory perception and cognitive development in infants who use cochlear implants, and suggests several new directions for research addressing multisensory exploration and cognitive development in infants with cochlear implants.     

Computer‐assisted reading intervention with a phonics approach for children using cochlear implants or hearing aids

The present study examined computer‐assisted reading intervention with a phonics approach for deaf and hard of hearing (DHH) children in Sweden using cochlear implants or hearing aids, or a combination of both. The study included 48 children, 5, 6 and 7 years of age. Sixteen children with normal hearing (NH) served as a reference group. The first purpose of the study was to compare NH and DHH children's reading ability at pre and post‐intervention. The second purpose was to investigate effects of the intervention. Cognitive and demographic factors were analyzed in relation to reading improvement. Results showed no statistically significant difference for reading ability at the group level, although NH children showed overall higher reading scores at both test points. Age comparisons revealed a statistically significant higher reading ability in the NH 7‐year‐olds compared to the DHH 7‐year‐olds. The intervention proved successful for word decoding accuracy, passage comprehension and as a reduction of nonword decoding errors in both NH and DHH children. Reading improvement was associated with complex working memory and phonological processing skills in NH children. Correspondent associations were observed with visual working memory and letter knowledge in the DHH children. Age was the only demographic factor that was significantly correlated with reading improvement. The results suggest that DHH children's beginning reading may be influenced by visual strategies that might explain the reading delay in the older children.     

Programming maintenance after correspondence training interventions with children

Interventions were employed to program maintenance following correspondence training. The use of reinforcement of verbalization and a mixed sequence of procedures designed to establish indiscriminable contingencies was evaluated in multiple-baseline designs across subjects and behaviors. The results indicated that target behaviors were maintained under less intrusive interventions and in the absence of programmed contingencies during extended follow-up conditions. The results are discussed in terms of changes in reinforcement schedules established in maintenance interventions.     

Acquisition and generalization of manual signs by hearing-impaired adults with mental retardation

Behavioral procedures have been used to teach manual communication skills to individuals with mental retardation, although few studies have examined the assessment of generalization of such skills beyond the teaching environment. In this study, we investigated the effectiveness of directed rehearsal for teaching and facilitating the generalization of manual signs by six hearing-impaired adults with mental retardation. The effects of directed rehearsal, alone and combined with positive reinforcement for correct responses, were compared to a no-training control condition in an alternating treatments design. Although directed rehearsal was superior to the no-training control condition in teaching manual signs, the procedure was more effective when combined with positive reinforcement. The combined procedure was used to facilitate the generalization of learned signs across a number of variables. The results showed that there were high levels of generalization by all participants across novel phrases, settings, and trainers but variable levels of generalization to another response mode by some subjects. Further, increased levels in overall vocal communication were found for most participants.     

Using multiple-exemplar training to teach a generalized repertoire of sharing to children with autism

The current study examined the utility of multiple-exemplar training to teach children with autism to share. Stimuli from 3 of 4 categories were trained using a treatment package of video modeling, prompting, and reinforcement. Offers to share increased for all 3 children following the introduction of treatment, with evidence of skill maintenance. In addition, within-stimulus-category generalization of sharing was evident for all participants, although only 1 participant demonstrated across-category generalization of sharing. Offers to share occurred in a novel setting, with familiar and novel stimuli, and in the presence of novel adults and peers for all participants during posttreatment probes.     

Effects of foreign mand training on the emergence of foreign tact and listener responses for Chinese-speaking children with autism spectrum disorder

In China, there is an increasing demand for preschool children with autism spectrum disorder (ASD) enrolled in general education to learn English vocabulary. The purpose of this study was to evaluate the effect of foreign mand training in English on the acquisition of mand responses, and the emergence of tact and listener responses for three Chinese-speaking preschool children (boys; 4–5 years of age) with ASD. Echoic-to-mand training was implemented to teach mands in English. The study employed a concurrent multiple-probe design across behaviors. The results of the study indicated that the training was effective in the acquisition of mand responses. Moreover, untaught tacts and listener responses for the same vocabulary emerged without explicit training. Implications for small-group mand training in foreign language acquisition were discussed.     

Further evaluation of emerging speech in children with developmental disabilities: training verbal behavior

The conceptual basis for many effective language-training programs are based on Skinner's (1957) analysis of verbal behavior. Skinner described several elementary verbal operants including mands, tacts, intraverbals, and echoics. According to Skinner, responses that are the same topography may actually be functionally independent. Previous research has supported Skinner's assertion of functional independence (e.g., Hall & Sundberg, 1987; Lamarre & Holland, 1985), and some research has suggested that specific programming must be incorporated to achieve generalization across verbal operants (e.g., Sigafoos, Reichle, & Doss, 1990). The present study provides further analysis of the independence of verbal operants when teaching language to children with autism and other developmental disabilities. In the current study, 3 participants' vocal responses were first assessed as mands or tacts. Generalization for each verbal operant across alternate conditions was then assessed and subsequent training provided as needed. Results indicated that generalization across verbal operants occurred across some, but not all, vocal responses. These results are discussed relative to the functional independence of verbal operants as described by Skinner.     

The effects of behavioral skills training on mand training by staff and unprompted vocal mands by children

We evaluated the effects of a training package, including instructions, modeling, rehearsal, and feedback, for training staff members to conduct mand training with children. Experimenters collected data on staff performance on each step of a task analysis of mand training and on unprompted child vocal mands. Training resulted in increases in staff performance in mand training and in unprompted mands by children. We observed replication of these effects across settings for all staff and for 3 of the children.