{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:14:40Z","timestamp":1760235280226,"version":"build-2065373602"},"reference-count":45,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:00:00Z","timestamp":1628121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Audiology Research"],"abstract":"<jats:p>Background: The purpose of this study was to investigate the effectiveness of aural-oral habilitation (AO) over the traditional speech-language therapy, based on the number of vocalization-volubility of a deaf child with late-mapping bilateral cochlear implants using sequential measurements. Methods: The spontaneous productions during child interactions were analyzed. The child (CY, 7;0 years old) with a mean unaided pure-tone average (PTA) hearing loss &gt;80 dB HL was assessed by using an assessment battery. Study design consisted of two phases: (a) baseline (end of speech therapy) and (b) end of AO treatment. Protophones were analyzed via acoustical analysis using PRAAT software. Results: One-way repeated-measure ANOVAs were conducted within and between phases. The analyses revealed significant differences between the \u2018phase\u2019 and the vocalization outcome (F = 9.4, df = 1, p = 0.035). Post hoc analyses revealed the significant difference between the mean number of disyllable vocalizations of AO approach (p = 0.05). The mean number of vocalizations was calculated for each protophone type, but no other significant difference was measured. Conclusions: AO approach proved effective as measured through volubility. The outcome of this study is indicative and is a starting point for broader research.<\/jats:p>","DOI":"10.3390\/audiolres11030035","type":"journal-article","created":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T21:43:53Z","timestamp":1628199833000},"page":"373-383","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of Aural-Oral Approach Based on Volubility of a Deaf Child with Late-Mapping Bilateral Cochlear Implants"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3850-1866","authenticated-orcid":false,"given":"Paris","family":"Binos","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol 3036, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Theodorou","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol 3036, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thekla","family":"Elriz","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol 3036, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kostas","family":"Konstantopoulos","sequence":"additional","affiliation":[{"name":"Department of Speech and Language Therapy, University of Peloponnese, 24100 Kalamata, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,5]]},"reference":[{"key":"ref_1","unstructured":"Cole, E.B., and Flexer, C. (2019). Children with Hearing Loss: Developing Listening and Talking Birth to Six, Plural Publishing."},{"key":"ref_2","unstructured":"Annison, J., Jenkinson, J., Sparrow, W., and Bethune, E. (1996). Communication Impairment. Disability, Disability Thomas Nelson."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1044\/2019_JSLHR-19-00158","article-title":"The Relationship between the Onset of Canonical Syllables and Speech Perception Skills in Children with Cochlear Implants","volume":"63","author":"Jung","year":"2020","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_4","first-page":"2041","article-title":"Atypical cortical responses underlie poor speech perception in children using cochlear implants","volume":"16","author":"Gordon","year":"2005","journal-title":"Neuro. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1159\/000046846","article-title":"Of Kittens and Kids: Altered Cortical Maturation following Profound Deafness and Cochlear Implant Use","volume":"6","author":"Ponton","year":"2001","journal-title":"Audiol. Neurotol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.jcomdis.2009.03.003","article-title":"Cortical development, plasticity and re-organization in children with cochlear implants","volume":"42","author":"Sharma","year":"2009","journal-title":"J. Commun. Disord."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e20163489","DOI":"10.1542\/peds.2016-3489","article-title":"CDaCI Investigative the CDaCI Investigative Team Early Sign Language Exposure and Cochlear Implantation Benefits","volume":"140","author":"Geers","year":"2017","journal-title":"Pediatrics"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"46S","DOI":"10.1097\/01.AUD.0000051689.57380.1B","article-title":"Language Skills of Children with Early Cochlear Implantation","volume":"24","author":"Geers","year":"2003","journal-title":"Ear. Hear."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e20151974-17","DOI":"10.1542\/peds.2015-1974","article-title":"Sign Language and Spoken Language for Children with Hearing Loss: A Systematic Review","volume":"137","author":"Fitzpatrick","year":"2016","journal-title":"Pediatrics"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2332","DOI":"10.1044\/2014_JSLHR-H-14-0190","article-title":"Speech Intelligibility in Deaf Children after Long-Term Cochlear Implant Use","volume":"57","author":"Montag","year":"2014","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_11","unstructured":"Estabrooks, W., Maclver-Lux, K., and Rhoades, E. (2016). Auditory-Verbal Therapy: For Young Children with Hearing Loss and Their Families, and the Practitioners Who Guide Them, Plural Publishing."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"39S","DOI":"10.1097\/AUD.0b013e3181fa41dc","article-title":"Language and Verbal Reasoning Skills in Adolescents with 10 or More Years of Cochlear Implant Experience","volume":"32","author":"Geers","year":"2011","journal-title":"Ear. Hear."},{"key":"ref_13","first-page":"111","article-title":"Individual Differences in Effectiveness of Cochlear Implants in Children Who Are Prelingually Deaf: New Process Measures of Performance","volume":"101","author":"Pisoni","year":"1999","journal-title":"Volta. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1177\/0003489400109S1254","article-title":"Speech Intelligibility of Prelingually Deaf Children with Multichannel Cochlear Implants","volume":"109","author":"Svirsky","year":"2000","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1111\/j.1467-9280.2008.02117.x","article-title":"Social Feedback to Infants\u2019 Babbling Facilitates Rapid Phonological Learning","volume":"19","author":"Goldstein","year":"2008","journal-title":"Psychol. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1111\/infa.12054","article-title":"Maternal Responsiveness and the Development of Directed Vocalizing in Social Interactions","volume":"19","author":"West","year":"2014","journal-title":"Infancy"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S0021-9924(99)00013-1","article-title":"Precursors to speech in infancy: The prediction of speech and language disorders","volume":"32","author":"Oller","year":"1999","journal-title":"J. Commun. Disord."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1044\/1092-4388(2001\/017)","article-title":"Beginning to talk at 20 months: Early vocal development in a young cochlear implant recipient","volume":"44","author":"Ertmer","year":"2001","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"6318","DOI":"10.1073\/pnas.1300337110","article-title":"Functional flexibility of infant vocalization and the emergence of language","volume":"110","author":"Oller","year":"2013","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_20","unstructured":"Davis, B., and Zajdo, K. (2008). Co-Occurrence Patterns in the Babbling of Children with a Cochlear Implant. The Syllable in Speech Production: Perspectives on the Frame Content Theory, Taylor and Francis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"115","DOI":"10.17955\/tvr.108.2.603","article-title":"Prelinguistic Vocal Development in Infants with Typical Hearing and Infants with Severe-to-Profound Hearing Loss","volume":"108","author":"Iyer","year":"2008","journal-title":"Volta. Rev."},{"key":"ref_22","unstructured":"Dobinson, C., and Wren, Y.E. (2019). Creating Practice Based Evidence: A Guide for SLTs, J & R Press. [2nd ed.]."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1097\/AUD.0000000000000829","article-title":"Prelinguistic Vocal Development in Children with Cochlear Prelinguistic Vocal Development in Children with Cochlear Implants: A systematic review","volume":"41","author":"McDaniel","year":"2020","journal-title":"Ear. Hear."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1111\/1460-6984.12102","article-title":"Specific language impairment: A convenient label for whom?","volume":"49","author":"Reilly","year":"2014","journal-title":"Int. J. Lang. Commun. Disord."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.jcomdis.2006.02.003","article-title":"Single subject controlled experiments in aphasia: The science and the state of the science","volume":"39","author":"Thompson","year":"2006","journal-title":"J. Commun. Disord."},{"key":"ref_26","unstructured":"LoBiondo-Wood, G., Haber, J., Cameron, C., and Singh, M. (2013). Nursing Research in Canada: Methods, Critical Appraisal, and Utilization, Elsevier. [3rd ed.]."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.rehab.2017.12.002","article-title":"Single-case experimental designs to assess intervention effectiveness in rehabilitation: A practical guide","volume":"61","author":"Evans","year":"2018","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_28","unstructured":"Stavrakaki, S., and Tsimpli, I.M. (2000). Diagnostic verbal IQ test for Greek preschool and school age children: Standardization, statistical analysis, psychometric properties. Proceedings of the Eighth Symposium of the Panhellenic Association of Logopedists, Ellinika Grammata."},{"key":"ref_29","unstructured":"Brown, L., Sherbenou, R.J., and Johnsen, S.K. (2010). Test of Nonverbal Intelligence, Pro-Ed.. [4th ed.]."},{"key":"ref_30","unstructured":"Stoel-Gammon, C., and Dunn, C. (1985). Normal and Disordered Phonology in Children, Pro. Ed."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"397","DOI":"10.2307\/414151","article-title":"From Babbling to Speech: A Re-Assessment of the Continuity Issue","volume":"61","author":"Vihman","year":"1985","journal-title":"Language"},{"key":"ref_32","unstructured":"Peter, B., and MacLeod, A.A.N. (2013). An acoustic phonetic catalog of prespeech vocalizations from a developmental perspective. Comprehensive Perspectives on Child Speech Development and Disorders: Pathways from Linguistic Theory to Clinical Practice, Nova Science Publishers, Inc."},{"key":"ref_33","unstructured":"Winitz, H. (1996). Development of vocalizations in infancy. Human Communication and Its Disorders: A Review, York Press. [4th ed.]."},{"key":"ref_34","unstructured":"Ling, D. (1976). Speech and the Hearing-Impaired Child: Theory and Practice, Alexander Graham Bell Association for the Deaf."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Ling, D. (1989). Foundations of Spoken Language for the Hearing-Impaired Child, Alexander Graham Bell Association for the Deaf.","DOI":"10.1097\/00003446-199008000-00013"},{"key":"ref_36","unstructured":"Alpiner, J.G., and McCarthy, P.A. (2000). Assessment and intervention with preschool children who are deaf and hard-of-hearing. Rehabilitative Audiology: Children and Adults, Lippincott Williams & Wil-kins."},{"key":"ref_37","unstructured":"Erber, N. (1982). Auditory Training, Alexander Graham Bell Association for the Deaf."},{"key":"ref_38","unstructured":"Hodson, B., and Paden, E. (1991). Targeting Intelligible Speech: A Phonological Approach to Remediation, Pro-Ed.. [2nd ed.]."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1044\/0161-1461.1703.199","article-title":"Remediation of Common Phonological Processes. Four case studies","volume":"17","author":"Monahan","year":"1986","journal-title":"Lang. Speech Hear. Serv. Sch."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1749-818X.2008.00079.x","article-title":"Speech Development in Prelingually Deaf Children with Cochlear Implants","volume":"3","author":"Bouchard","year":"2008","journal-title":"Lang. Linguist. Compass"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1177\/0003489400109S1233","article-title":"Speech Perception in Young Children Using Nucleus or Clarion Cochlear Implants: Effect of Communication Mode","volume":"109","author":"Young","year":"2000","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1097\/MAO.0b013e3182839650","article-title":"Communication Outcomes for Groups of Children Using Cochlear Implants Enrolled in Auditory-Verbal, Aural-Oral, and Bilingual-Bicultural Early Intervention Programs","volume":"34","author":"Dettman","year":"2013","journal-title":"Otol. Neurotol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"84S","DOI":"10.1097\/AUD.0b013e3181ffd5b5","article-title":"Epilogue: Factors Contributing to Long-Term Outcomes of Cochlear Implantation in Early Childhood","volume":"32","author":"Geers","year":"2011","journal-title":"Ear Hear."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"121S","DOI":"10.1097\/01.AUD.0000052759.62354.9F","article-title":"Epilogue: Major Findings, Conclusions and Implications for Deaf Education","volume":"24","author":"Moog","year":"2003","journal-title":"Ear Hear."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1097\/00003446-200212000-00004","article-title":"A Sensitive Period for the Development of the Central Auditory System in Children with Cochlear Implants: Implications for Age of Implantation","volume":"23","author":"Sharma","year":"2002","journal-title":"Ear Hear."}],"container-title":["Audiology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4349\/11\/3\/35\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:41:15Z","timestamp":1760164875000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4349\/11\/3\/35"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,5]]},"references-count":45,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["audiolres11030035"],"URL":"https:\/\/doi.org\/10.3390\/audiolres11030035","relation":{},"ISSN":["2039-4349"],"issn-type":[{"type":"electronic","value":"2039-4349"}],"subject":[],"published":{"date-parts":[[2021,8,5]]}}}