Effects of an Online Music Program on Expressive Vocabulary, Maternal Stress, and Acoustic Environment in Children with Cochlear Implants

INTRODUCTION: Language development in children with cochlear implants (CIs) shows considerable variability, influenced by a range of environmental and relational factors. Among these, early exposure to music has received growing attention, as music and language may share overlapping neural mechanisms. Musical engagement in early childhood may not only support vocabulary growth but also foster positive parent-child interactions. Parental well-being, particularly maternal stress, is another important factor: mothers of children with CIs could report elevated stress levels related to communication challenges and caregiving demands, which can in turn affect child outcomes. Additionally, the acoustic environment plays a key role in shaping auditory and language development. Children with CIs are exposed to a less detailed auditory signal than their hearing peers, and poor listening conditions can further compromise speech perception and learning. AIM: This study examined the effects of a 12-week online music program for early-implanted children and their mothers. The intervention aimed to promote children’s vocabulary development and reduce maternal stress, while also exploring the influence of the acoustic environment. METHOD: Sixteen children with CIs (mean age = 17.6 months) and their mothers participated in the music program (CI-T group). Sixteen age-matched children with CIs (mean age = 18.5 months) with their mothers received standard treatment without music intervention (CI-C group). The music program began three months after CI activation. All participants were assessed at three time points: before the program (T1), immediately after (T2), and six months after the end of the program (T3). Child’s vocabulary was measured using the MacArthur-Bates Communicative Development Inventories (MB-CDI), maternal stress using the Parenting Stress Index–Short Form (PSI-SF), and acoustic environment exposure using datalogging from the children’s CIs, focusing on daily hours of “speech in quiet.” RESULTS: Results showed in the CI-T group significant improvements in expressive vocabulary between T1 and T2, and between T2 and T3. In contrast, the CI-C group exhibited significant improvements only between T2 and T3. Regarding maternal stress, only the CI-T group had a significant reduction on the “Difficult Child” subscale of the PSI-SF between T1 and T2, while there were no significant changes the CI-C group. Correlational analyses across both groups showed that increases in children’s expressive vocabulary were significantly associated with decreases in maternal stress, particularly in perceptions of the child as difficult or the relationship as dysfunctional. Moreover, increased exposure to speech in quiet was positively associated with vocabulary growth and negatively associated with maternal stress. DISCUSSION: In conclusion, this study provides preliminary evidence that early, home-based music interventions may enhance vocabulary development in children with CIs and reduce maternal stress during the first months after CI activation. It also highlights the role of other factors, such as a good acoustic environment, which has a beneficial impact on both the child’s vocabulary development and the mothers’ perceived stress.