Bidirectional language influence in mother–child interaction and its effects on the communicative development of children with cochlear implants: A longitudinal study

The present study aimed to investigate the communicative characteristics of children with cochlear implants (CIs) and their mothers in interaction, whether and how they differ from those of mother-child dyads with normal hearing, and whether mother and child influence each other over the first year after implantation. Eighteen Italian-speaking children with CIs were assessed longitudinally across four time points, from before implantation (ages: 10-33 months) to 1 year after implantation. Two groups of normally-hearing children matched for age or lexical production level were used as comparison groups. The language used by mothers in semi-structured play sessions with their children was analyzed for use of specific techniques aimed at eliciting language in children with CIs (or Facilitating Language Techniques [FLTs]: questions, labeling, comments, parallel talk, reformulations, and directives); children's language was analyzed for communicative functions (initiatives and adequate responses). Results showed delayed communicative development for children with CIs with respect to both control groups and different use of FLTs such as directives between mothers of children with or without normal hearing. Findings also highlighted an effect of the interlocutor's communicative behavior for both children and mothers: In the group of children with CIs, children's initiatives were hindered by a higher use of questions; mothers' labeling was negatively affected by children's responsivity. Findings may have important implications for language development support programs, families, and professionals.