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Audition and Visual Attention: The Developmental Trajectory in Deaf and Hearing Populations
Audition and Visual Attention: The Developmental Trajectory in Deaf and Hearing Populations
Richard Miyamoto
Indiana University School of Medicine
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
This study examined the development of visual attention in 5- to 13-year-olds who differed in their
This document is copyrighted by the American Psychological Association or one of its allied publishers.
access to sound. Hearing children, deaf children with cochlear implants, and deaf children without
implants participated in a task in which they were to respond to some visual signals and not others.
The results of Experiment 1 indicated that the timing of developmental changes in visual selective
attention was similar for all 3 groups, occurring around 8 years. The magnitude of age-related change
differed among groups; hearing children and older deaf children using a cochlear implant reached
higher levels of performance with age than did deaf children without enhanced access to sound. The
results of Experiment 2 suggest that the developmental differences between deaf children with and
without cochlear implants begin prior to 8 years and may be related to their use of environmental
sounds to organize visual attention.
Shortly after birth, newborns look in the direction of sound from hearing children on visual selective attention tasks that
(e.g., Mendelson & Haith, 1976; Wertheimer, 1961). With fur- involved no sound. Moreover, they found that profoundly deaf
ther development, this early control of visual attention by sound children who had access to auditory information through a co-
quickly becomes more complicated, such that infants look at chlear implant performed more like hearing children. And, criti-
visual events whose temporal rhythms match what they hear cally for the specific question we ask here, these differences
(e.g., Kuhl & Meltzoff, 1988; Spelke, 1979; Walker-Andrews, emerged and increased from younger to older children.
1988; Walker-Andrews & Lennon, 1991). Other evidence sug- Quittner et al. (1994) used a continuous visual performance
gests that corresponding sights and sounds lead to deeper visual task that involved no sounds at all. The task is one that has been
processing by infants, children, and adults (Butterworth, 1981; widely used to identify children with serious attentional deficits
Morrongiello, 1994; Perrot, Saberi, Brown, & Strybel, 1990; in the clinical literature (Barkley, 1988; Gordon, 1986, 1987). It
Roberts, 1994; Roberts & Jacobs. 1991). In brief, from early in requires sustained visual attention or vigilance over a fairly long
development, sound plays a role in organizing visual attention. period of time, the discrimination of targets from nontargets,
It seems likely that this tight coupling between what the devel- and selective responding to the target information alone. More
oping child hears and where he or she looks organizes the child's specifically, children were presented with a continuous stream of
behavior and learning (Smith, 1994; Smith & Katz, 1996). numbers and were asked to press a button whenever a sequence
If this is so, if hearing and seeing strongly interact in the of two digits ( " 1 " then " 9 " ) occurred in succession.
control of visual attention, what happens when one modality is The children were grouped into two broad age ranges: 6- to
lost? This article addresses this question by examining how the 8-year-olds and 9- to 13-year-olds, and they fell into one of three
loss of hearing influences the development of visual selective hearing-status groups: normally hearing children, severely to
attention. Our starting point is a study reported by Quittner, profoundly deaf children, and profoundly deaf children who had
Smilh, Osberger, Mitchell, and Katz (1994). They found that been using a cochlear implant for at least 1 year. A cochlear
profoundly deaf children performed substantially differently implant is a device that digitizes sound and stimulates the co-
chlea at different points, providing direct input about acouslic
events (see Staller, Beiter, & Brimacombc, 1994). Thus, the
Linda B. Smith and Alexandra L. Quittner, Department of Psychology, deaf children in this last group had, relative to the other deaf
Indiana University Bloomington; Mary Joe Osberger, Advanced Bionics children, enhanced access to auditory information.
Corporation, Boston, Massachusetts; Richard Miyamoto, Department of Quittner et al. (1994) found an interaction between age and
Otolaryngology, Indiana University School of Medicine.
hearing status. At the younger age level, both groups of deaf
This research was supported in part by Biomedical Research Grant
children performed similarly and more poorly than the hearing
PHS RR7031-27, an Indiana University Intercampus Grant, and National
Institute on Deafness and Other Communication Disorders Grant DC children. At the older age level, however, hearing children and
00064. deaf children using cochlear implants performed well and much
Correspondence concerning this article should be addressed to Linda better than the other deaf children. In contrast, older deaf chil-
B. Smith, Department of Psychology Indiana University, Bloomington, dren without implants performed more poorly than even the
Indiana 47405. Electronic mail may be sent to smith4@indiana.edu. youngest hearing children. In brief, the deaf children had consid-
AUDITION AND VISUAL ATTENTION 841
erable difficulty in a demanding visual selective attention task, delayed course of attentional development. The problem with
but older deaf children who used a cochlear implant appeared this account is the good visual selective attention shown by the
to * 'catch up'' and performed as well as their hearing peers. older deaf children with cochlear implants. Although Quittner
To our knowledge, Quittner et al.'s (1994) results are the first et al. did not measure the deaf children's language skills, past
experimental findings documenting the altered development of research comparing deaf children with and without implants
visual selective attention in deaf children. This study, however, suggests that the deaf children in Quittner et al.'s study would
follows a long line of anecdotal and clinical reports of atten- not differ in their language skills (Quittner et al., 1994).
tional problems in deaf children (R. I. Harris, 1978; Quittner, A third possibility emerges from considering how seeing and
Glueckauf, & Jackson, 1990). The clear implication is that ac- hearing normally interact in the control of visual attention. Hear-
cess to auditory information plays a role in the development of ing individuals often use audition to monitor both their near and
selective attention. Results showing that older deaf children with their far world for changing events, while allowing vision to
a cochlear implant perform similarly to hearing children further focus narrowly on the task at hand. When a new event is signaled
supports the idea that access to sound benefits the development by sound, they then shift visual attention appropriately. In con-
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
of visual selective attention. It is important that both samples trast, deaf individuals must use vision both to monitor the world
This document is copyrighted by the American Psychological Association or one of its allied publishers.
of children (those with and without implants) in the Quittner for new events and to accomplish the immediate task (see Mitch-
et al. sample were comparable: In their second experiment, the ell, 1996; Mitchell & Smith, 1996; Neville, 1990). Thus, while
children were recruited from the same otolaryngology clinic hearing individuals may develop a highly selective, task-oriented
and attended similar kinds of schools and language programs. visual attention, deaf individuals may adaptively develop a more
Thus, the effect of the implant on children's visual attention distributed visual attention. The advantage of a cochlear implant
does not appear to be due in any direct way to population for deaf children may be that it allows them to more effectively
differences extraneous to the implant. use sound to monitor the environment for new information, thus
enabling visual attention to become more selective. This third
hypothesis motivated the present study.
Why Should Deaf Children Perform Poorly
in This Attention Task?
Why Does a Cochlear Implant Benefit Older and Not
One hypothesis often raised in the older literature on sensory Younger Deaf Children's Selective Attention?
deficits suggests that deaf children are underaroused because of
a lack of stimulation (Levine, 1971). If deaf children's poor If an implant provides sufficient information for the develop-
selective attention stemmed from such underarousal, one might ment of selective visual attention, why did only the older deaf
hypothesize that the cochlear implant benefits attention by in- children with an implant show this advantage? One possibility
creasing the quantity of sensory input and thus arousal. There is that younger deaf children have difficulty learning to use their
is, however, little support for this underarousal hypothesis in the implant, a training and adjustment process that typically takes
literature (see, e.g., Wood, 1991). Furthermore, two aspects of 6 months (Osberger, 1986). There is, however, no evidence that
Quittner et al.'s (1994) study suggest the implausibility of this younger children have greater difficulty than older children with
account. First, there were no observable differences in arousal this process (Staller et al., 1994). Moreover, all that is known
levels or task interest in the two groups of deaf children. Second, about perceptual learning would suggest that younger rather than
both groups of deaf children in that study had auditory stimula- older children would more readily adapt to and learn to use the
tion during the course of the task—one group through a co- new sensory input (see Aslin & Smith, 1988). Indeed, cochlear
chlear implant and the other group through hearing aids. implants are now being given to toddlers and preschoolers with
This is a potentially important point. Virtually all deaf chil- some success (Staller et al., 1994).
dren use some type of sensory aid. And deafness, even profound A second possibility is that the selective attention task used
deafness, is neither uniform nor complete (Staller et al., 1994). by Quittner et al. (1994) is too difficult for younger children
Thus, both the deaf children with hearing aids and those with and thus not sensitive to the potentially small gains in visual
cochlear implants had access to auditory information—but the attention made by younger deaf children using an implant. This
nature of that information was very different. Hearing aids am- possibility is plausible given the difficulty of the task for all
plify a broad spectrum of frequencies with some temporal delay young children, including hearing children. Moreover, because
and imprecision. In contrast, implants directly stimulate the au- the age groups in the Quittner et al. study were broad, it is
ditory nerve, presenting limited spectral information with fine- possible that there is some benefit to visual selective attention
grained temporal resolution. Thus, it would not seem to be from an implant that is being masked by the poor performance
stimulation and arousal but the kind of auditory information of the very youngest children. We examined these two possibili-
available that explains the results. ties in the present study by using finer age distinctions in Experi-
A second possibility concerns the role of language. Many ment 1 and a simpler attention task than used by Quittner et al.
developmentalists have suggested that communication with oth- in Experiment 2.
ers and self is the process through which behavioral control and A third and more theoretically interesting possibility is that
selective attention develop (Berk, 1986; Luria, 1961; Vygotsky, the influence of a cochlear implant on the development of visual
1962). Many deaf children (and all the deaf children in Quittner selective attention must wait until visual attention starts to de-
et al.'s [1994] study) have hearing parents and thus diminished velop rapidly. An extensive literature on selective attention skills
communicative experiences early in lite. Therefore, these deaf in hearing children suggests that the time of most rapid change
children might reasonably be expected to show an altered or begins around the ages of 5 to 7 years (Aslin & Smith, 1988).
842 SMITH, QUITTNER, OSBERGER, AND MIYAMOTO
implants. We ask whether advances in visual selective attention 500 102.51 6.41 73.10 24.11
This document is copyrighted by the American Psychological Association or one of its allied publishers.
occur in the same way for all groups. Are there differences 1000 113.79 7.51 84.00 27,19
among the groups in the timing of developmental change? Are 2000 113.75 7.48 88.02 30.52
there differences in the magnitude of developmental change?
We address these questions in two experiments using cross-
sectional designs. The first tests children from 6 to 13 years of cochlear implant (CI) group. These were deaf children who had received
age, and the second more closely examines children from 4 to a cochlear implant from the Department of Otolaryngology at the Indiana
7 years of age. University School of Medicine. All of these children were prelingually
and profoundly deaf (i.e., 90 dB loss or greater) as determined by
audiologists. Table 1 shows the mean unaided auditory threshold (i.e.,
Experiment 1
widi implant turned off). These children had received their implants as
This experiment uses the same continuous visual performance recently as 6 months prior to testing or as long as 6 years 6 months. The
task used by Quittner et al (1994). Use of this task was moti- implanted devices were of two types: single channel (i.e., 1 electrode,
vated by four considerations. First, the goal was to replicate the 3-M House; Fretz & Fravel, 1985) and multichannel (i.e., 22 electrodes,
Nucleus; Patrick & Clark. 1991). Of the 51 children in this group, 44
Quittner et al. findings with a larger group of children. Second,
had received implants within the last 4 years and used the 22-channel
there are well-established performance norms on this task de- device, and 7 who had their implants longer used the single-channel
rived from over 1,000 children ages 4 to 16 years (Gordon, device. Children were tested during their regular visits to set and check
1987). Third, performance on this task has been shown to be the device at the Department of Otolaryngology. As listed in Table 2,
predictive of clinical levels of attention deficit disorder (Barkley, these children had diverse educational experiences, including residential
1988). Fourth, Mitchell and Quittner (1996) showed that perfor- programs, private day schools for the deaf, separate classrooms in the
mance in this task was predictive of behavioral problems of public school, and regular public classrooms. Also listed in Table 2 is
deaf children both in the classroom and at home. The limitation the etiology of deafness, which is commonly unknown.
of this task and all continuous performance tasks is that they Fifty-one prelingually deaf children without implants were matched
do not provide a fine-grained measure of specific components to the CI group by age and composed the deaf control (DC) group.
of attention. However, we believe that a global measure of the Twenty-nine of these children were recruited from patients at the same
developmental trajectory in a task predictive of real-world atten- clinic and were being evaluated for or waiting to receive an implant at
tional performance is the proper starting point for this line of the time of the test; these children were tested at the clinic during their
regular visits. Twenty-two children were recruited from and tested at
research.
the Eastern North Carolina School for the Deaf. The mean unaided
As in the earlier Quittner et al. (1994) study, the present auditory threshold for the children in the DC group is also provided in
study tested three groups of children: hearing children, deaf Table 1. These thresholds are slightly better than the unaided thresholds
children who used a cochlear implant, and a control group se- of children using cochlear implants. Of these 51 DC participants, 45
lected from the larger population of deaf children. Because the used a conventional hearing aid, and 6 used a vibrotactile aid (a device
deaf children who elect to receive implants and their families that delivers acoustic energy to transducers worn on the skin; Franklin,
may differ from other deaf children, care was taken in the selec- 1991). Although many of these children used hearing aids, the unaided
auditory thresholds are such that even with a hearing aid, they receive
tion of the deaf control group to include two populations: deaf
only minimal auditory information. Types of schooling, language train-
children who were patients at the same medical facility as the ing, and etiology of deafness for the children in this group are also listed
children who used implants and were under consideration for in Table 2.
an implant and deaf children who attended a residential school Fifty-one hearing children matched in age to the children using co-
for the deaf. The children in each group ranged in age from 6 chlear implants were recruited from participant files maintained by the
to 13 years. In an effort to plot the developmental trajectory of developmental psychology program of the Department of Psychology of
visual selective attention for each group, we used narrow age Indiana University. These children composed the hearing control (HC)
groupings and a relatively large sample. group.
Task and procedure. Children were tested individually in a quiet
room. Deaf children were tested by one of three professionals fluent in
Method
American Sign Language and Signed English. Instructions were pre-
Participants. The participants were 153 children. Of these, 51 were sented to deaf children in the mode preferred by the participants. For
deaf children who had received a cochlear implant and composed the hearing children, instructions were in spoken English. Practice trials
AUDITION AND VISUAL ATTENTION 843
Table 2 yielded main effects of group, F(2, 135) = 60.74, p < .001,
Demographic Characteristics of Children in Experiment 1 and age, F ( 5 , 135) = 15.87, p < .001, and an interaction
between Group X Age, F(10, 135) = 1.89, p = .05. Post hoc
Characteristic and type Cochlear implant Hearing aid Vibrotactile comparisons (Newman-Keuls, p < .05) indicated that at the
3 youngest three age levels, both groups of deaf children per-
Educational setting
Fully mainstreamed 10 3 0 formed reliably more poorly than did hearing children, and the
Remedial-resource 8 5 1 two groups of deaf children did not differ from each other.
Self-contained 19 5 2 However, for each of the older three age groups, children in the
Residential 9 19 3 CI group performed reliably better than did children in the DC
Day school 0 9 0
group.
Language modeb
Total communication 23 34 2 The shape of the age-related functions provides some insight
Oral 27 10 4 into these findings. The most marked gain in performance for
Etiology hearing children occurred between the ages of 7 and 8 years.
Unknown 23 25 1
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Meningitis 19 9 4 For both groups of deaf children, the most marked gains in
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mean d primes were 2.29 for younger oral children, 1,75 for
younger TC children, 3.40 for older oral children, and 3.38 for
older TC children. We submitted each rf-prime score for each
child in the CI group to a 2 (age) X 2 (mode) ANOVA. The
analysis revealed a highly reliable main effect of age, F{ 1, 46)
= 19.69, p< .01. Neither the effect of mode, F( 1,46) < 1.00,
nor the interaction, F{ 1, 46) < 1.00, approached significance.
Subgroups among the DC group. The DC group also con-
tained several subgroups whose performances we examined in-
dependently. First 28 of these children attended the same oto-
laryngology clinic as did the CI children and were like the CI
children in that they were from families interested in considering
an implant and in the mixed nature of their schooling experi-
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residential day school for the deaf and thus were immersed in
the language and culture of the deaf community. The perfor-
mances of these two groups of children in the visual attention
task as measured by d prime did not differ reliably; for the
clinic-tested children, the mean equaled 2.83; for the school-
tested children, the mean equaled 2.64, f(49) - 0.67.
AGE (in years) Six of the clinic-tested children in the DC group used a vibro-
tactile aid rather than a hearing aid. Because this device provides
Figure 1. Mean d prime as a function of age for the three groups of children with augmented access to sound, it is plausible that
children in Experiment 1. CI = cochlear implant group; DC = deaf a vibrotactile aid, like a cochlear implant, might benefit the
control group; HC = hearing control group. development of visual attention. There was no evidence for this
in our extremely small sample of children using the vibrotactile
aid. Their mean d prime in the continuous performance task
a substantial proportion of deaf children in both groups did so. was 2.27, a level of performance comparable to the DC group
At the younger age levels, 6 to 8 years, 52% of the children as a whole.
using cochlear implants and 26% of the children in the DC Summary, The results from Experiment 1 provide new in-
group performed at or below the 5th percentile. At the older age formation about the course of the development of visual selective
levels, 9 to 13 years, the performances of 18% of the children attention in the three populations.
using cochiear implants and 39% of the children in the DC First, the timing of major developmental change in this task
group fell in this range. occurred between 7 and 9 years of age, with deaf children just
Length of time using a cochlear implant. If use of a cochlear slightly delayed behind hearing children. Whatever the internal
implant provides enhanced access to sound in ways that promote or external factors relevant to the timing of age-related changes
the development of visual selective attention, then one might in sustained selective attention, they appeared to operate simi-
expect that the length of use of the device would be correlated larly across all the groups of children studied.
with performance in the visual attention task. However, we found Second, the magnitude of age-related gains differed among
no correlation between d prime and length of use of the implant the groups. Children in the HC and DC groups showed similar
(r = .08). All children in this study had their implant at least developmental functions, differing principally in the absolute
6 months. Thus, it may be that the gains in access to sound level of performance. CI children showed the largest and most
relevant to visual attention occur rapidly postimplant (see Quitt- protracted gains, shifting from a level of absolute performance
ner et al., 1994). comparable to the DC group to one that approached the HC
Communication mode. As evident in Table 2, many children group. Moreover, where gains in performance were still evident
in the CI group used primarily the oral mode of communication, among the oldest CI groups, performance appeared to have
whereas the majority of children in the DC group used total plateaued by 9 years of age in the DC group. These results
communication (TC). Mode of communication is a potential strongly suggest that access to sound in some way contributes
force in the development of visual attention (see Neville & to the development of visual selective attention.
Lawson, 1987). Effective lipreading requires focused attention To gain further insight into this possibility, we conducted
to small details; comprehending sign language also requires Experiment 2. In this second experiment, we used a simpler
skilled attention to rapid changes in complex visual events. Thus, selective attention task to ask whether younger children using
although it is not obvious a priori which mode of communication a cochlear implant might show measurable gains in selective
might benefit the development of visual selective attention, it is attention earlier than suggested by the results of Experiment 1.
quite plausible that one mode might be more advantageous to
success in our task than the other. Experiment 2
To address this issue, we examined the performance of
younger (6-8-year-old) and older (9-13-year-old) children In this experiment, we used a simplified version of the same
in the CI group who used either oral communication or TC. The continuous performance task used in Experiment 1. In the clmi-
AUDITION AND VISUAL ATTENTION 845
cal literature (Gordon, 1986), this simpler task is also widely Table 5
used to identify younger children with attentional deficits. In Mean Hits, False Alarms, d Primes, and Meaningful Auditory
this task, the child is asked to press a button whenever the digit Integration Scale (MAIS) Scores of Children in Experiment 2
" 0 " appears in a continuous stream. This, then, is a simple
Group
detection task—press whenever the target appears and do not
press otherwise. This task, however, requires sustained focused Hearing aid Cochlear implant
attention to the changing events on the CRT screen.
Variable M SD M SD
Method Correct responses
Participants. Thirty-six prelingually and severely to profoundly deaf (hit rate) .50 .29 .61 .27
children were recruited from the same otolaryngology clinic. As shown Incorrect responses
in Table 1, the unaided auditory thresholds were higher for the CI chil- (false alarms) .10 .09 .06 .06
d prime 1.49 0.98 2.02 0.90
dren than for the DC children. The CI group consisted of 18 children
MAISa
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DC Group CI Group
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50 60 70 SO 90 100 50 60 70 80 90 100
Figure 2. Scatter plot of the relation between each participant's d prime and age in Experiment 2, DC =
deaf control; CI = cochlear implant.
with performance in the visual attention task. Figure 3 shows implant device raises perplexing questions about just how and
the scatter plots of individuals' d primes as a function of chil- why access to sound is related to visual selective attention. Our
dren's scores on the MAIS. There was a reliable relation be- results strongly suggest that the use of a cochlear implant leads
tween the two measures for the CI children (r = .56, p < .05) to the development of skilled visual attention, but our results
but not for the DC children (r = .30). Thus, enhanced sensitivity also suggest no relation between length of time an implant has
to sound and visual selective attention appeared to change to- been used and success in the visual attention task. The CI chil-
gether in these younger deaf children with implants. These re- dren and the DC children in this experiment were recruited from
sults, together with those of Experiment 1, suggest that sensitiv- the same population, and thus population differences seem an
ity to environmental sounds is related to the beginning of devel- unlikely source of the better task performance.
opmental changes in the control of visual attention. One possible explanation is that the relevant effects of implant
Just as in Experiment 1, for children in the CI group, there use occur rapidly postsurgery (see Quittner et al., 1994, for a
was no relation between time with the implant and performance similar suggestion). We have some data pertinent to this issue-
on the task (r = .20). The lack of relation between participants' Six children—4 participants from Experiment 1 and 2 partici-
performance on the task and length of time they had used an pants from Experiment 2—were tested twice in the attention
DC Group CI Group
a.
a
5 10 5 10
Reported sensitivity to sound Reported sensitivity to sound
Figure 3. Scatter plot of the relation between each participant's d prime and parent report of the partici-
pant's sensitivity to sound in Experiment 2. DC = deaf control; CI - cochlear implant.
AUDITION AND VISUAL ATTENTION 847
Q 2
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This document is copyrighted by the American Psychological Association or one of its allied publishers.
task, once presurgery and once postsurgery. Thus, for these 6 of greatest gain occurred about I year earlier for hearing chil-
children, we can report pre- and postimplant performance on dren than for children in both deaf groups. The fact that the
the visual attention task. timing of developmental change was similar for all groups pro-
These 6 children's pre- and postimplant d primes are shown vides new information about the development of attention and
in Figure 4. The graph shows performance as a function of the its relation to hearing. Whatever the control parameter that orga-
age of the participant at the time of the test. The average time nizes change at this developmental point, it is apparently inde-
between tests was 9 months, and the time between hookup of pendent of access to sound. The timing of developmental change
the implant device and the second test in our task was 6 months in all three populations might be controlled by internal factors
for all children. As is apparent, performance on the visual atten- such as the maturation of inhibitory processes in the frontal
tion task postimplant increased for 5 of the 6 children and did lobe (see, e.g., Diamond, 1990). Alternatively, the timing of
so quite dramatically for 3 of them. One cannot make strong developmental change might be externally driven, perhaps by
conclusions from these results because of the small number of the increased demands of schooling in early childhood. Either
participants and because we have no control for the effects of way, the timing of the developmental shift in this continuous
repeated testing. However, these data are consistent with the performance task was altered only slightly by deafness.
idea that the relevant effects of the implant can be rapid; these In contrast, the level of overall performance and the magni-
effects are apparently not realized in successful task perfor- tude of developmental change appear to be strongly dependent
mance until a certain point in development is attained. on the kind of access to sound. The results of Experiment 1
indicated dramatic differences in the magnitude of age-related
General Discussion change among the three groups of children, hunger deaf chil-
dren using a cochlear implant performed most poorly and con-
We asked in our introduction to this article why deaf children siderably less well than hearing children. However, between the
should perform poorly on visual attention tasks. The answer to ages of 8 and 9, performances by children in this group shifted
this question will provide important insights into development to approach that of their hearing peers. Performances by children
in the deaf population as well as into the processes that underlie in the deaf control group increased to a much lesser degree.
the development of attention more generally. Our goal was to Indeed, performance for this group appeared to asymptote at a
provide evidence relevant to this question by examining the level below that of the youngest hearing children. The results
course of age-related changes across three groups of children: of Experiment 2 further suggest that there are beginning signs
hearing children, deaf children, and deaf children with enhanced of the attentional differences to come at earlier ages: hunger
access to sound through a cochlear implant. children in the CI group showed both more sensitivity to envi-
The results of Experiment 1 suggest that the timing of devel- ronmental sounds and slightly better performance on a simpler
opmental change was similar across the three groups. The timing visual attention task.
SMITH, QUITTNER, OSBERGER, AND MIYAMOTO
This pattern of results suggests that highly selective visual Hypothetical Trajectories
attention is the product of a complex system that includes multi-
Component 1 — selectivity
ple components. Our results provide hints toward the nature of
this system and its dependence on sound. The first clue is the — Component 2 — access to sound
strong relationship between performance and age. Whatever
sound a cochkar implant provides, it is nol well used in the — Performance in Task
service of visual attention until 8 or 9 years of age. The second
clue is that gains in selective attention as a consequence of a
child's using a cochlear implant happen within months of receiv-
ing the implant. Hearing
child
sounds, that this responsiveness is correlated with the improve- In summary, the present results provide new information
ments of younger children in a simpler attention task, and finally, about the development of visual selective attention generally
that gains in visual selective attention among older children do and also about its development in deaf children. Attentional
not require extended use of the implant device. Suggestive as development has broad implications for other achievements in
these data are, the model in Figure 5 and the division-of-labor the deaf population, such as reading, conceptual thinking, and
hypothesis clearly need more direct empirical support. Still, the classroom performance (Quittner et al., 1990). One relevant
present results point to an attentional system made up of many issue is increased impulsivity and distractibility reported in deaf
developing and interacting components. children. Indeed, the ability to focus attention in this laboratory
Another pressing question for future work is the precise na- task has been shown to be related to classroom behavior and
ture of the sound that is necessary for the development of good behavioral problems at home (Mitchell & Quittner, 1996). Un-
selective attention. Deaf children without cochlear implants have derstanding how visual selective attention comes to be organized
some access to sound and typically use some device such as a and the role of sound in that organization may ultimately enable
hearing aid to bolster auditory input. Why, then, is the auditory us to affect the behavioral development of deaf children.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
Mitchell, T. V. (1996). How audition shapes visual attention. Unpub- Siegler, R. S. (1991). Children's thinking. Englewood Cliffs, NJ: Pren-
lished doctoral dissertation, Indiana University Bloomington. tice Hall.
Mitchell, T. V, & Quittner, A. (1996). Multimethod study of attention Smith, L. B. (1994). Foreword. In D. J. Lewkowicz & R. Lickliter
and behavior problems in hearing-impaired children. Journal of Clini- (Eds.), The development of intersensory perception: Comparative
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Roberts, K., & Jacobs, M. (1991). Linguistic vs. attentional influences Received March 27, 1997
on nonlinguistic categorization in 15-month-old infants. Cognitive Revision received December 22, 1997
Development, 6, 355—375. Accepted December 23, 1997 •
In the article "Developing Organization of Mental Verbs and Theory of Mind in Middle Child-
hood: Evidence From Extensions," by Paula J. Schwanenflugel, Robbie L. Henderson, and William
V. Fabricius (Developmental Psychology, 1998, Vol. 34, No. 3, pp. 512-524), Figures 2 and 4 were
inadvertently switched. The figure appearing on page 519 is Figure 4, and the data pertain to third
graders; the figure appearing on page 521 is Figure 2, and the data pertain to adults.