Improvements in visual attention in deaf infants and toddlers after cochlear implantation

Alexandra L. Quittner, David H. Barker, Carolyn Snell, Ivette Cruz, Lynda Grace Mcdonald, Mary E. Grimley, Melissa Botteri, Kristen Marciel, Laurie Eisenberg, William Luxford, Karen Johnson, Amy Martinez, Jean Des-Jardin, Leslie Visser-Dumont, Sophie Ambrose, Carren Stika, Melinda Gillinger, John Niparko, Jill Chinnici, Howard FrancisSteve Bowditch, Jennifer Yeagle, Courtney Carver, Andrea Marlowe, Andrea Gregg, Jennifer Gross, Rick Ostrander, Nancy Mellon, Jennifer Mertes, Mary O'Leary Kane, Annelle Hodges, Thomas Balkany, Alina Lopez, Leslie Goodwin, Teresa Zwolan, Mary Beth O'Sullivan, Anita Vereb, Caroline Arnedt, Holly F.B. Teagle, Carolyn J. Brown, Craig A. Buchman, Carlton Zdanski, Hannah Eskridge, Emily Tobey, Andrea Warner-Czyz, Deborah Rekart, Carol Cokely, Nicole Weissner, Angela Boyd, Nancy Fink, Nae Yuh Wang, Daniel Habtemariam, Thelma Vilche, Patricia Bayton

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


The aims of this study were to examine the development of visual attention in deaf and hearing infants and toddlers, and assess whether improvements in visual attention were observed in the deaf sample after 12 months of cochlear implantation. A novel puppet task, based on a measure of attention developed with normally hearing infants, was administered to 88 deaf and 42 normal-hearing children at three time points: baseline, six and 12 months post-implantation for the deaf sample. At baseline, deaf children demonstrated significantly more inattentive looks during the puppet skits than hearing children, and these looks were of longer duration, confirming the results of prior studies which have documented deficits in visual attention in deaf children. Longitudinal analyses showed significant decreases in the frequency of inattentive looks for both groups, with a significant decrease in the duration of inattentive looks only for the cochlear implant group. The largest decrease in duration of off-task looks occurred at six months post-implantation, indicating that improvements occurred rapidly after restoration of auditory input. These results provided support for the 'division of labor' hypothesis which suggests that deaf children with no access or limited access to sound must monitor their environment visually, making it difficult for them to focus and attend to specific tasks. Cochlear implantation appeared to alter the developmental trajectory of visual attention in a positive manner. The clinical implications of visual attention for the development of early language, reading and social skills are discussed.

Original languageEnglish
Pages (from-to)242-249
Number of pages8
JournalAudiological Medicine
Issue number4
StatePublished - 2007


  • 'Division of labor' hypothesis
  • Auditory information
  • Brain plasticity
  • Cochlear implants
  • Visual attention


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