Contribution of family environment to pediatric cochlear implant users' speech and language outcomes: Some preliminary findings

Purpose: To evaluate the family environments of children with cochlear implants and to examine relationships between family environment and postimplant language development and executive function. Method: Forty-five families of children with cochlear implants completed a self-report family environment questionnaire (Family Environment Scale-Fourth Edition; Moos & Moos, 2009) and an inventory of executive function (Behavior Rating Inventory of Executive Function [Gioia, Isquith, Guy, & Kenworthy, 2000] or Behavior Rating Inventory of Executive Function-Preschool Version [Gioia, Espy, & Isquith, 2003]). The authors also evaluated children's receptive vocabulary (Peabody Picture Vocabulary Test-Fourth Edition; Dunn & Dunn, 2007) and global language skills (Preschool Language Scale-Fourth Edition [Zimmerman, Steiner, & Pond, 2002] and Clinical Evaluation of Language Fundamentals-Fourth Edition [Semel, Wiig, & Secord, 2003]). Results: The family environments of children with cochlear implants differed from those of normal-hearing children but not in clinically significant ways. Language development and executive function were found to be atypical but not uncharacteristic of this clinical population. Families with higher levels of self-reported control had children with smaller vocabularies. Families reporting a higher emphasis on achievement had children with fewer executive function and working memory problems. Finally, families reporting a higher emphasis on organization had children with fewer problems related to inhibition. Conclusion: Some of the variability in cochlear implantation outcomes that have protracted periods of development is related to family environment. Because family environment can be modified and enhanced by therapy or education, these preliminary findings hold promise for future work in helping families to create robust language-learning environments that can maximize their child's potential with a cochlear implant.