This research describes the development of communicative intention of young children with cochlear implants in order to study the relationship between the early communicative intention of these children and their later verbal communication. Five children under the age of three years with cochlear implants were selected from the records of the University of Stellenbosch, Tygerberg Academic Hospital’s Cochlear Implant Unit, Cape Town as subjects. Video recordings of each of the five subjects in unstructured free play interaction with their caregivers, before cochlear implantation and each six months after cochlear implantation over a period of two years were used to identify the development of their communicative intention. The Communicative Intention Inventory (Coggins&Carpenter, 1981) was used to classify the communicative behaviour of the subjects according to the types of communication functions that were used, as well as the way in which they expressed the functions of communication. Results of the study show that the development course of the functions of communication that the subjects used over a two-year period, were consistent with the development patterns found in younger children with normal hearing. There was however marked individual differences between the subjects during the transition from nonverbal to dominantly verbal ways of communication as far as the rate of development of verbal communication was concerned. A strong relationship was found among the five subjects regarding the use of the nonverbal communication functions, request for object or action and protest before cochlear implantation and their total verbal communication two years after cochlear implantation, which could account for these individual differences in the rate of verbal communication development after cochlear implantation. Indications for clinical application and future research were identified on the basis of these conclusions. The data collected during the research is seen as meaningful in clinical decision-making regarding the suitability of young children under the age of three years with a profound hearing loss for cochlear implantation and their therapeutic management. / Dissertation (M (Communication Pathology))--University of Pretoria, 2006. / Speech-Language Pathology and Audiology / Unrestricted

Abstract The preverbal vocalisation up to the first word, feeding skills as well as motor development until the first steps of ELBW preterm infants without disability were compared in this descriptive study to those of healthy full-term infants. In addition, preverbal and feeding skills were studied in relation to gross motor movement patterns. The preverbal development of preterm infants proceeded according to the same temporal schedule as that of full-term infants, however, preterm infants failed to produce several vocalisation skills that full-term infants presented. The preterm infants increased their vocalisation slower than the full-term infants in the beginning of each of the developmental stages. The difference between the preterm and the full-term infants grew when approaching syllables, syllable combinations, and words. The preterm infants reached the first word approximately two months later than the full-term infants. The suckling of preterm infants was either disorganised or dysfunctional, while normal or disorganised in the case of full-term infants. The preterm infants reached the spoon-feeding skills approximately at the same (corrected) ages as the full-term infants, but the transitions to new stages were difficult. Half of the preterm infants suffered from feeding problems while only two of the full-term infants had feeding problems. Both the preterm and full-term infants reached vocalisation and feeding skills in relation to gross motor movement patterns earlier than assumed according to the predominant clinical knowledge. The vocalisation and feeding skills did not seem to be dependent upon the gross motor development. / Tiivistelmä Tässä kuvailevassa tutkimuksessa tarkasteltiin tiiviissä seurannassa erittäin ennenaikaisina ja pienipainoisina syntyneiden lasten esileksikaalista ääntelyä ensisanaan asti sekä syömistaitojen ja motoriikan kehitystä ensiaskeliin asti. Tuloksia verrattiin terveiden, täysiaikaisina syntyneiden lasten vastaaviin taitoihin. Lisäksi ääntelyn ja syömisen kehitystä tarkasteltiin suhteessa karkeamotoristen taitojen kehitysaikatauluun. Ennenaikaisesti syntyneiden lasten ääntely kehittyi saman aikataulun mukaan kuin täysiaikaisten lasten ääntely. Ennenaikaisesti syntyneet lapset jättivät kuitenkin väliin taitoja, jotka täysiaikaisina syntyneet lapset saavuttivat. Siirryttäessä uusille ääntelyn ja kielen kehitystasoille ennenaikaisina syntyneiden lasten ääntelyn määrä lisääntyi hitaammin kuin täysiaikaisina syntyneiden lasten ääntelyn määrä. Ero ennenaikaisina ja täysiaikaisina syntyneiden lasten kehityksessä kasvoi lähestyttäessä tavuja, tavuyhdistelmiä ja sanoja. Ennenaikaisesti syntyneet lapset saavuttivat ensisanavaiheen kaksi kuukautta täysiaikaisia lapsia myöhemmin. Ennenaikaisina syntyneiden lasten syömisen taidoissa havaittiin, että varhainen imeminen oli joko jäsentymätöntä tai poikkeavaa, kun täysiaikaisina syntyneillä se oli puolestaan normaalia tai jäsentymätöntä. Ennenaikaisina syntyneet lapset oppivat käsittelemään soseita ja kiinteitä ruokia samassa (korjatussa) iässä kuin täysiaikaisina syntyneet lapset, mutta siirtyminen kehitysvaiheesta toiseen tuotti vaikeutta. Puolet ennenaikaisista lapsista kärsi syömisvaikeuksista. Sen sijaan täysiaikaisina syntyneistä lapsista kahdella todettiin syömisen vaikeutta. Sekä ennenaikaisina että täysiaikaisina syntyneet lapset oppivat ääntelyn ja syömisen taitoja ennen tiettyjä karkeamotorisia liikemalleja, joiden on vallitsevan kuntoutuskäsityksen mukaisesti oletettu edeltävän näiden taitojen saavuttamista. Ääntelyn ja syömisen taidot eivät siis näyttäneet olevan riippuvaisia karkeamotoriikan kehityksestä.

No description available.