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Influencing Outcomes for Children Who Are Deaf-Blind with Cochlear Implants Project

Wednesday, July 7, 2010

Data Collection Revolution

How LENA Pro Helped Me Streamline My Research Strategy for a Cochlear Implant Study

Great advancements in technology can transform the lives of young children. One such innovation is the cochlear implant. Over the past five years, it has become increasingly common for children who are not just deaf but deaf-blind to receive implants. For children with no or minimal auditory and visual perception, the implants have the potential to facilitate learning and increase independence.

In 2005 my colleagues at the Teaching Research Institute and University of Kansas and I received a grant to determine outcomes and predictive variables for these kids. To collect assessment data, we spent time in homes and schools where we observed many parents and teachers who did not seem to increase their amount of speech to the children with the new implants. It was common, for instance, to observe a parent or teacher feed a child but not say more than five words in the process.

We started wondering how the implant would benefit the child if the child heard very little speech. To find out, we wrote another grant to look at the quality and quantity of parent talk before and after cochlear implantation and to develop intervention strategies to help influence outcomes. Our plan was to videotape the children and their caregivers in their natural environments to determine the amount of parent talk.

Around the time the grant* was funded, in 2008, I was invited to visit a LENA (Language ENvironment Analysis) Foundation exhibit at an early childhood conference. On the morning of the conference, I decided to attend a poster session. As it turned out, the session featured Dr. Charles Greenwood, who displayed child outcome data he had obtained with the LENA System. I had a feeling that something in the universe was trying to tell me something.

After all, the logistics of our data collection plan presented some challenges. Once the children are eligible and approved for an implant, many are scheduled for the surgery to be performed very quickly; there is often a short turnaround time, sometimes within 10 days. I realized that it was likely that there wouldn't be enough time to purchase a reasonably priced airline ticket and fly out to do the actual videotaping before each surgery.

That's when I had an epiphany. Instead of flying around the country videotaping children, we could simply send out LENA Clothing and the LENA Digital Language Processor (DLP) to the parents, collect data across a child's waking hours, and look at the child's audio environment and amount of speech directed to the child. I went from the presentation to the LENA booth and, after discussing the technology further with LENA representatives, ordered LENA Pro, a number of DLPs, and vests.

After a child is referred to our project, instead of hopping a flight we send the parents a brochure and "LENA letter" and then follow up with them over the phone. If they are interested in using LENA, we overnight them three DLPs and a very cute LENA Clothing item that has a pocket specially designed to hold the DLP. The parents use the DLPs three times during the week, taking notes on their child's routines and activities on each recording day, and then send the materials back. We use LENA Pro to process the data; with the LENA data and the notes, we can see the number of adult words spoken during key periods, such as lunchtime, playtime, playtime with siblings, or car rides. In addition to adult words, we can observe the number of child vocalizations and adult-child conversational turns; we're also considering using the LENA Advanced Data Extractor (ADEX) tool to assess the quality of adult-child interactions. Even though we haven't met them face to face, most of the parents are thrilled with the idea of using LENA; they love outfitting their kids in the cute LENA rompers and overalls and, ultimately, receiving the colored graphs depicting their child's language and audio environment. Other parents have shown interest in using LENA to help inform their decision on whether or not to have their child undergo cochlear implant surgery. Some families have even used LENA data to advocate for an FM system in their child's preschool environment. Currently, 13 families are involved in our research at different phases. We have just sent out post-implant DLPs to three families. Since we are in the early phase of our research, we do not have results at this time. Ultimately, we will use LENA to look at generalization across the entire day. As pediatric cochlear implantation has improved progress for many children who are deaf-blind, LENA has the potential to improve the lives of young children. Not only can the technology assist in measuring cochlear implantation outcomes, it also has the potential to be used to influence outcomes for many families and their children. As a result, LENA has been a perfect fit for our research and outcome objectives.

* The research discussed in this article is funded by the U.S. Department of Education, Office of Special Education - Technology and Media Services for Individuals with Disabilities (CFDA 84.327A). Grant H327A080045; Opinions expressed within are those of the author and do not necessarily represent the position of the U.S. Department of Education.

Article included with permission from the LENA (Language ENvironment Analysis) Foundation eNewsletter http://www.lenafoundation.org/Resources/Newsletter.aspx?PageMethod=ViewNewsletter&newsletterToken=20100601

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