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This thesis deals with the issue of speech therapy for children of early school age with the cochlear implant. General knowledge about hearing impairment and the possibility of compensation, different types of cochlear implants and especially about the specifics and methodology of following speech therapy are summarized in the theoretical part of the thesis. The practical part consists of research, realized through questionnaires. The research deals with the current situation of speech therapy for children of early school age with a cochlear implant, with a special focus on post-implantation rehabilitation and its complexity. The result of the research demonstrates the complexity of speech therapy only in some speech therapy workplaces. The result of the research also demonstrates that speech therapy is highly individual and depends completely on specific situation and personality and communication skills of each child with a cochlear implant. KEYWORDS Hearing impairment, cochlear implant, cochlear implantation, child with a cochlear implant, early school age, rehabilitation, hearing and speech developement, speech therapy.

The content of this thesis is a theoretical introduction to the topic of hearing impairment, its classification, diagnosis and compensation options. Furthermore the work deals with a cochlear implant as the compensation aid. It describes the entire process of choosing the cochlear implantation candidates, the operation itself, setting of the speech processor and subsequent rehabilitation. The thesis also deals with communication competence and speech development not only of children with hearing impairment but also without hearing disorders. After the performance of the available diagnostic tools used for vocabulary testing, the work describes a research process of identifying the vocabulary level in children with cochlear implants by the use of appropriate passive and active vocabulary test and interprets obtained results. KEYWORDS: cochlear implant, communication skills, passive vocabulary, active vocabulary, a child with a cochlear implant, Test of the passive and active vocabulary

L’objectif principal de ce travail est de recueillir la parole des parents entendants d’un enfant sourd porteur d’un implant cochléaire, sur les représentations de leur parentalité de leur point de vue et sur le rôle joué par l’implant au niveau de la communication et la transmission intergénérationnelle au sein de ces constellations familiales. Le groupe d’étude était composé de 55 parents d’un enfant sourd implanté cochléaire et de 31 parents d’enfants sans handicap. Les stratégies de coping ont été explorées au moyen de l’échelle WCC-R privilégiant la dimension transactionnelle selon la théorie de Lazarus et Folkman. Les représentations de la parentalité ainsi que le rôle de l’implant dans la transmission intergénérationnelle ont été analysés par le biais d’entretiens semi-directifs. Les résultats montrent que ces familles ont tendance à mobiliser un coping plus actif que ne le font des parents d’enfants sans handicap. Ils se positionnent en règle générale sur des savoirs-action leur permettant de faire à face à des situations potentiellement aversives du fait de la surdité de leur enfant. En outre, les parents du groupe d’étude expriment une satisfaction de leur parentalité d’un enfant sourd implanté qui malgré, l’épreuve vécue au moment de l’annonce du diagnostic, se façonne au fil du temps et des expériences partagées avec leur enfant.Ils s’inscrivent pleinement en qualité de parents responsables du projet de l’implant choisi entre autres pour l’avenir de leur enfant et pour partager un sentiment d’aperception tout en cultivant pour certains, par l’apprentissage et la pratique de la LSF, la dimension culturelle naturelle de leur enfant. / The main objective of this work is to gather the voice of hearing parents of a deaf child with cochlear implant, on the representations of their parenthood from their point of view and on the role played by the implant at communication and intergenerational transmission levels within these family constellations.The study group was composed of 55 parents of a cochlear implanted deaf child and 31 parents of children without disabilities. The coping strategies were explored using the WCC-R scale, favoring the transactional dimension according to the Lazarus and Folkman theory. The representations of parenthood and the role of the implant in the intergenerational transmission were analyzed through semi-directive interviews. The results show that these families tend to mobilize a more active coping than the parents of children without disabilities. They generally position themselves on knowledge-action enabling them to deal with potentially aversive situations due to the deafness of their child. Furthermore, the parents of the study group express a satisfaction with their parenting of a deaf child with implants, which, despite the ordeal experienced at the time of the diagnosis, is being shaped over time and through experiences shared with their child. They fully embrace themselves as parents responsible for the implant project chosen – among other reasons – for their child's future and to share a sense of apperception, while cultivating for some of these parents, through the learning and practice of the LSF, the natural cultural dimension of their child.

Made available in DSpace on 2014-06-11T19:29:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2000Bitstream added on 2014-06-13T18:59:12Z : No. of bitstreams: 1 mesquita_st_me_fran.pdf: 838474 bytes, checksum: 4d5f2aef31c9f6c219d82ca618e65057 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / A deficiência auditiva, em função da sua alta incidência, tem recebido da comunidade científica uma atenção especial na criação de dispositivos que viabilizem a (re)habilitação de seus portadores. Como uma alternativa para os portadores de deficiência auditiva neurossensorial profunda bilateral, surgiu o Implante Coclear - que envolve ato cirúrgico para a implantação de eletrodos na cóclea - que permite ao deficiente auditivo, uma audição útil, que viabilize ou melhore sua comunicação. Esta pesquisa refere-se aos usuários do Implante coclear, implantados no Centro de Pesquisas Audiológicas (CPA) do Hospital de Reabilitação de Anomalias Craniofaciais (HRAC) da Universidade de São Paulo (USP). Até junho de 2000, eram 163. O objetivo deste trabalho é traçar um perfil desse universo, chegando às repercussões do Implante Coclear (IC) na vida de seus usuários, por meio de uma amostra de 34 usuários. O que se constatou foi uma concentração de pacientes procedentes da região sudeste - mais especificamente Estado de São Paulo - pertencentes às classes menos favorecidas, que têm como expectativa inicial o Implante Coclear (IC). As demais categorias apresentam diferenças que, no entanto, não transparecem nas repercussões do IC na vida de seus usuários. As repercussões pesquisadas foram em nível de satisfação, mudanças na vida diária - no caso de crianças, mudança na vida dos pais também - e preocupações com relação ao IC. A maioria dos sujeitos da amostra (97.0%) esta satisfeita com o IC e concorda que, em virtude dele, ocorreram mudanças em suas vidas - a maioria positiva - sem, no entanto, descartar as preocupações decorrentes do uso do IC, que giram em torno dos dispositivos interno e externos (fragilidade e manutenção, em virtude dos custos). A realidade constatada é objeto de intervenção da Assistente Social, que... / The hearing loss, due to its high incidence has received special attention from the scientific community in the development and improvement of devices adressed to the hearing impaired people. The Cochlear Implant -surgery envolving electrode implantation inside the cochlea -an alternative to those who have bilateral profound sensorineural hearing loss. It provides to the hearing impaired people a useful hearing which improves their communication. This research is about Cochlear Implant (CI) users, who underwent surgery in the Centro de Pesquisas Audiológicas (CPA) from the Hospital de Reabilitação de Anomalias Craniofaciais (HRAC) of University of São Paulo. Until June/2000 totalized 163 cases. The aim of this study is to delineate the profile of those patients (the total) and to get to the CI repercussions in their lives, a sample of 34 cases was analysed. It was verified that there is a concentration of patients coming from the Southeast region - more specifically, from São Paulo state - belonging to the lowers classes and have the CI as a initial expectation. The others verified categories show differences that neverthless, do not appear in the CI repercussions in the users lives. The researched repercussions were related to satisfaction, changes in the daily life - with the children, changes in the parents lives too - and concerns about the CI. The majority of the subjects from the sample (97.0%) is satisfied with the CI and report positive changes in their lives without dismissing their concerns resulting from the CI use, that is about the external and internal devices (its fragility and maintenance, due the cost). The established reality is the object of the social worker intervention. This study, is an attempt to enlarge the knowledge about ...(Complete abstract, click electronic access below)

The aim of this dissertation project is to describe the ways people experience parenting a deaf child who uses a cochlear implant. Within a framework of social science studies of disability this is done by combining approaches using ethnographic and netnographic methods of participant observation with an interview study. Interpretations are based on the first-person perspective of 19 parents against the background of their related networks of social encounters of everyday life. The netnographic study is presented in composite conversations building on exchanges in 10 social media groups, which investigates the parents’ meaning-making in interaction with other parents with similar living conditions. Ideas about language, technology, deafness, disability, and activism are explored. Lived parenting refers to the analysis of accounts of orientation and what 'gets done' in respect to these ideas in situations where people utilize the senses differently. In the results, dilemmas surrounding language, communication and cochlear implantation are identified and explored. The dilemmas extend from if and when to implant, to decisions about communication modes, intervention approaches, and schools. An important finding concerns the parents’ orientations within the dilemmas, where most parents come up against antagonistic conflicts. There are also examples found of a development process in parenting based on lived, in-depth experiences of disability and uncertainty which enables parents to transcend the conflictive atmosphere. This process is analyzed in terms of a social literacy of dis/ability.

Cette thèse porte sur la perception visuelle, auditive et audiovisuelle des voyelles nasales [ɑ̃] (« lent »),[ɔ̃] (« long ») et [ɛ̃] (« lin ») par des adultes devenus sourds, implantés cochléaires et implantés dutronc cérébral. L’étude sur la perception visuelle des voyelles, auprès de 22 adultes devenus sourds,redéfinit les sosies labiaux des voyelles nasales et propose une mise à jour de la classification desvisèmes. Trois études sur l’identification auditive des voyelles nasales auprès de 82, 15 et 10 adultesimplantés cochléaires mettent en évidence leur difficulté à reconnaitre les trois voyelles nasales, qu’ilsperçoivent comme des voyelles orales. Les analyses acoustiques et perceptives suggèrent que lesadultes implantés cochléaires s’appuient sur les informations fréquentielles des deux premiers picsspectraux mais négligent les informations d’intensité relative de ces pics. D’après l’étude menéeauprès de 13 adultes implantés du tronc cérébral, des informations acoustiques linguistiques sonttransmises par l’implant du tronc cérébral mais la fusion entre les informations auditives et visuellespourrait être optimisée pour l’identification des voyelles. Enfin, une enquête auprès de 179orthophonistes pointe le besoin d’une information sur la définition phonétique articulatoire actualiséedes voyelles [ɑ̃] et [ɛ̃]. / This thesis focuses on the visual, auditory and auditory-visual perception of french nasal vowels [ɑ̃](« lent »), [ɔ̃] (« long ») and [ɛ̃] (« lin ») by Cochlear Implant (CI) and Auditory Brainstem Implant(ABI) adults users. The study on visual perception of vowels, with 22 deafened adults, redefines thelip configuration of french nasal vowels and provides an update of the classification of vocalic visualphonemes. Three studies on auditory identification of nasal vowels with 82, 15 and 10 CI usershighlight their difficulty in recognizing the three nasal vowels, which they perceive as oral vowels.Acoustic and perceptual analyzes suggest that adults with CI rely on frequency informations of thefirst two spectral peaks but miss the informations of relative intensity of these peaks. The study with13 ABI users show that some linguistic acoustic cues are transmitted by the ABI but the fusion ofauditory and visual features could be optimized for the identification of vowels. Finally, a survey of179 Speech Language and Hearing Therapists show the need of an update on the phonetic articulationof french nasal vowels [ɑ̃] and [ɛ̃].

Le bénéfice de l’implant cochléaire pour la compréhension de la parole en milieu calme, et même dans certains cas pour des situations auditives complexes telles que les environnements bruyants ou l’écoute de la musique est aujourd’hui connu. Si la compréhension de la parole est nécessaire à la communication, la perception des informations non verbales transmises par la voix de même que des expressions faciales est fondamentale pour interpréter le message d’un interlocuteur. Les capacités de perception des émotions non verbales en cas de surdité neurosensorielle évolutive ont été très peu explorées. Les travaux menés dans cette thèse ont pour objectifs d’évaluer la reconnaissance des émotions non verbales dans les modalités auditive et visuelle afin de mettre en évidence d’éventuelles spécificités chez les adultes présentant une surdité évolutive. Pour cela, nous avons réalisé quatre études comportementales dans lesquelles nous avons comparé leurs performances à celles de sujets contrôles normo-entendants. Nous avons évalué le jugement des émotions portées par la musique, la voix et les visages à partir d’un paradigme expérimental impliquant la reconnaissance de catégories émotionnelles (i.e. joie, peur, tristesse...) et la perception des dimensions de valence et d’éveil de l’émotion exprimée. Les études 1 et 2 ont porté sur la reconnaissance des émotions auditives après implantation cochléaire en examinant tour à tour la reconnaissance des émotions portées par la musique et la reconnaissance de celles portées par la voix. Les études 3 et 4 ont porté sur la reconnaissance des émotions visuelles et, en particulier, des expressions faciales avant et après implantation cochléaire. Les résultats de ces études révèlent l’existence d’un déficit de reconnaissance des émotions plus marqué dans le domaine musical et vocal que facial. Il apparaît aussi une perturbation des jugements d'éveil, les stimuli étant perçus moins excitants par les patients que par les normo-entendants. Toutefois, la reconnaissance des voix et des musiques, bien que limitée, était supérieure au niveau du hasard démontrant les bénéfices de l'implant cochléaire pour le traitement des émotions auditives. En revanche, quelle que soit la modalité étudiée, les jugements de valence n'étaient pas altérés. De manière surprenante, les données de ces recherches suggèrent de plus que, chez une partie des patients testés, la reconnaissance des émotions faciales peut être affectée par la survenue d'une surdité évolutive suggérant les conséquences de la perte auditive sur le traitement des émotions présentées dans une autre modalité. En conclusion, il semblerait que la surdité, de même que l'insuffisance d’informations spectrales transmises par l’implant cochléaire, favorisent l'utilisation de la communication verbale au détriment de la communication non verbale. / While cochlear implantation is quite successful in restoring speech comprehension in quiet environments other auditory tasks, such as communication in noisy environments or music perception remain very challenging for cochlear implant (CI) users. Communication involves multimodal perception since information is transmitted by vocal and facial expressions which are crucial to interpret speaker’s emotional state. Indeed, very few studies have examined perception of non verbal emotions in case of progressive neurosensorial hearing loss in adults. The aim of this thesis was to test the influence of rehabilitation by CI after acquired deafness on emotional judgment of musical excerpts and in non verbal voices. We also examined the influence of acquired post-lingual progressive deafness on emotional judgment of faces. For this purpose, we conducted four experimental studies in which performances of deaf and cochlear implanted subjects were compared to those of normal hearing controls. To assess emotional judgment in music, voices and faces, we used a task that consisted of emotional categories identification (happiness, fear, anger or peacefulness for music and neutral) and dimensional judgment of valence and arousal. The first two studies evaluated emotional perception in auditory modality by successively examining recognition of emotions in music and voices. The two following studies focused on emotion recognition in visual modality, particularly on emotional facial expressions before and after cochlear implantation. Results of these studies revealed greater deficits in emotion recognition in the musical and vocal than visual domains as well as a disturbance of arousal judgments, stimuli being perceived less exciting by CI patients as compared to NH subjects. Yet, recognition of emotions in music and voices, although limited, was performed above chance level demonstrating CI benefits for auditory emotions processing. Conversely, valence judgments were not impaired in music, vocal and facial emotional tests. Surprisingly, results of these studies suggest that, at least for a sub-group of patients, recognition of facial emotions is affected by acquired deafness indicating the consequences of progressive hearing loss in processing emotion presented in another modality. Thus, it seems that progressive deafness as well as the lack of spectral cues transmitted by the cochlear implant might foster verbal communication to the detriment of the non verbal emotional communication.