Symbolic play and novel noun learning in deaf and hearing children: Longitudinal effects of access to sound on early precursors of language

Alexandra L. Quittner, Ivette Cejas, Nae Yuh Wang, John K. Niparko, David H. Barker, Howard Francis, Steve Bowditch, Rick Ostrander, Dawn Marsiglia, Jennifer Yeagle, Nancy Mellon, Meredith Ouellette, Meredith Dougherty, Patricia Gates-Ulanet, Julie Verhoff, Annelle Hodges, Thomas Balkany, Alina Lopez, Leslie Goodwin, Teresa ZwolanCaroline Arnedt, Hussam El-Kashlam, Kelly Starr, Ellen Thomas, Jennifer Still, Holly F B Teagle, Craig A. Buchman, Carlton Zdanski, Hannah Eskridge, Harold C. Pillsbury, Jennifer Woodard, Laurie S. Eisenberg, Karen Johnson, William Luxford, Leslie Visser-Dumont, Amy Martinez, Dianne Hammes Ganguly, Carren J. Stika, Emily A. Tobey, Ann Geers, Lana Britt, Janet Lane, Peter Roland, Sujin Shin, Madhu Sundarrajan

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


In the largest, longitudinal study of young, deaf children before and three years after cochlear implantation, we compared symbolic play and novel noun learning to age-matched hearing peers. Participants were 180 children from six cochlear implant centers and 96 hearing children. Symbolic play was measured during five minutes of videotaped, structured solitary play. Play was coded as "symbolic" if the child used substitution (e.g., a wooden block as a bed). Novel noun learning was measured in 10 trials using a novel object and a distractor. Cochlear implant vs. normal hearing children were delayed in their use of symbolic play, however, those implanted before vs. after age two performed significantly better. Children with cochlear implants were also delayed in novel noun learning (median delay 1.54 years), with minimal evidence of catch-up growth. Quality of parent-child interactions was positively related to performance on the novel noun learning, but not symbolic play task. Early implantation was beneficial for both achievement of symbolic play and novel noun learning. Further, maternal sensitivity and linguistic stimulation by parents positively affected noun learning skills, although children with cochlear implants still lagged in comparison to hearing peers.

Original languageEnglish (US)
Article numbere0155964
JournalPloS one
Issue number5
StatePublished - May 1 2016

ASJC Scopus subject areas

  • General


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