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Hawthorne K. A meta-analysis of expressive prosody in cochlear implant users. JOURNAL OF COMMUNICATION DISORDERS 2024; 110:106431. [PMID: 38781923 DOI: 10.1016/j.jcomdis.2024.106431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 02/29/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Prosody is used to express indexical (identifying the talker), linguistic (e.g., question intonation, lexical stress), pragmatic (e.g., contrastive stress, sarcasm), and emotional/affective functions. It is manifested through changes in fundamental frequency (f0), intensity, and duration. F0 and intensity are degraded when perceived through a cochlear implant (CI). The purpose of this meta-analysis is to compare expressive prosody in speech produced by CI users versus normal hearing peers. METHODS A systematic search of the literature found 25 articles that met all inclusion criteria. These articles were assessed for quality, and data pertaining to the expression of f0, intensity, and duration, as well as classification accuracy and appropriateness ratings from normal hearing listeners, were extracted and meta-analyzed using random effects models. RESULTS The articles included in the meta-analysis were generally of acceptable or high quality. Meta-analyses revealed significant differences between individuals with CIs vs. normal hearing on all measures except mean f0, mean intensity, and rhythm. Effect sizes were generally medium to large. There was significant heterogeneity across studies, but little evidence of publication bias. CONCLUSIONS CI users speak with less variable f0, smaller f0 contours, more variable intensity, a slower speech rate, and reduced final lengthening at syntactic boundaries. These acoustic differences are reflected in significantly poorer ratings of speech produced by CI users compared to their normal hearing peers, as assessed by groups of normal hearing listeners. Because atypical expressive prosody is associated with negative outcomes, clinicians should consider targeting prosody when working with individuals who use CIs.
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Affiliation(s)
- Kara Hawthorne
- Gallaudet University, Department of Hearing, Speech, and Language Sciences, Sorenson Language and Communication Center, Washington, D.C. 20002, United States.
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Jafari Z, Fitzpatrick EM, Schramm DR, Rouillon I, Koravand A. Predictors of cochlear implant outcomes in pediatric auditory neuropathy: A matched case-control study. PLoS One 2024; 19:e0304316. [PMID: 38809896 PMCID: PMC11135674 DOI: 10.1371/journal.pone.0304316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/10/2024] [Indexed: 05/31/2024] Open
Abstract
OBJECTIVES Current evidence supports the benefits of cochlear implants (CIs) in children with hearing loss, including those with auditory neuropathy spectrum disorder (ANSD). However, there is limited evidence regarding factors that hold predictive value for intervention outcomes. DESIGN This retrospective case-control study consisted of 66 children with CIs, including 22 with ANSD and 44 with sensorineural hearing loss (SNHL) matched on sex, age, age at CI activation, and the length of follow-up with CIs (1:2 ratio). The case and control groups were compared in the results of five open-set speech perception tests, and a Forward Linear Regression Model was used to identify factors that can predict the post-CI outcomes. RESULTS There was no significant difference in average scores between the two groups across five outcome measures, ranging from 88.40% to 95.65%. The correlation matrix revealed that younger ages at hearing aid fitting and CI activation positively influenced improvements in speech perception test scores. Furthermore, among the variables incorporated in the regression model, the duration of follow-up with CIs, age at CI activation, and the utilization of two CIs demonstrated prognostic significance for improved post-CI speech perception outcomes. CONCLUSIONS Children with ANSD can achieve similar open-set speech perception outcomes as children with SNHL. A longer CI follow-up, a lower age at CI activation, and the use of two CIs are predictive for optimal CI outcome.
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Affiliation(s)
- Zahra Jafari
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ottawa, Ontario, Canada
- School of Communication Sciences and Disorders (SCSD), Dalhousie University, Halifax, NS, Canada
| | - Elizabeth M. Fitzpatrick
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ottawa, Ontario, Canada
- Child Hearing Lab, CHEO Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - David R. Schramm
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Isabelle Rouillon
- Speech and Language Pathology, and Otolaryngology Department, Necker Hospital, Paris, France
| | - Amineh Koravand
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ottawa, Ontario, Canada
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Roque Reis LS, Gani K, André, Peres C, Nunes G, Santos R, O'Neill A, Escada P. [Adaptation and Validation for European Portuguese of the Auditory Performance Categories-II and Infant-Toddler Meaningful Auditory Integration Scale for Children with Cochlear Implant]. ACTA MEDICA PORT 2024; 37:334-341. [PMID: 38498908 DOI: 10.20344/amp.20169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/07/2023] [Indexed: 03/20/2024]
Abstract
INTRODUCTION The Categories of Auditory Performance II (CAP-II) scale and the Infant-Toddler Meaningful Audit Integration Scale (IT-MAIS) are simple and quick questionnaires that allow assessment of the auditory performance of children with cochlear implant (CI). The aim of this study was to translate, adapt and validate the European Portuguese version of the CAP-II and IT-MAIS scales. METHODS A total of 85 participants completed the European Portuguese version of the CAP-II and IT-MAIS questionnaires, of which 45 were parents of children with pediatric cochlear implants (9.84 ± 4.22 years) and another 40 were parents of children with normal hearing (8.35 ± 3.56 years). Inter-rater reproducibility, test-retest reproducibility, comparison of study group versus control group results, internal consistency and correlation of the new scales were evaluated. RESULTS The CAP-II and IT-MAIS scales showed high reliability and reproducibility, respectively, with an intraclass correlation coefficient (ICC) of 0.979 (p < 0.001) and a Spearman's correlation of 0.924 for the CAP-II scale, and an ICC of 0.932 (p < 0.001) and Spearman's correlation coefficient of 0.732 for the IT-MAIS scale. The IT-MAIS and CAP-II versions showed strong internal consistency (Cronbach's α coefficient value of 0.887 for the CAP-II scale and Spearman's positive correlation of 0.677 for the IT-MAIS scale, respectively) and allowed for the differentiation between children with normal hearing and post-implantation children (p = 0.001 and p < 0.001 respectively for each of the scales). There was no association between parental education and the results on the scales (p > 0.05). CONCLUSION The findings demonstrated that the European Portuguese version of these scales is a valid and reliable tool for assessing auditory performance in European Portuguese-speaking children with hearing loss.
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Affiliation(s)
- Luí S Roque Reis
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
| | - Kaamil Gani
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
| | - André
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
| | - Carlota Peres
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa. Portugal
| | - Gonçalo Nunes
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa. Portugal
| | - Ricardo Santos
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
| | - Assunção O'Neill
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
| | - Pedro Escada
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
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Hamed N, Alajmi N, Alkoblan FI, Alghtani YA, Abdelsamad Y, Alhussien A, Alhajress RI, Alhabib SF. The Chronological Evolution of Cochlear Implant Contraindications: A Comprehensive Review. J Clin Med 2024; 13:2337. [PMID: 38673610 PMCID: PMC11050773 DOI: 10.3390/jcm13082337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Cochlear implantation has emerged as a transformative intervention in addressing profound hearing loss, offering a paradigm shift in auditory rehabilitation for individuals with restricted auditory function. Throughout its history, the understanding of contraindications for cochlear implant (CI) surgery has evolved significantly. This review comprehensively analyzes the chronological advancements in the understanding of CI contraindications, examining studies conducted from historical timelines to the present. Recent research has revealed significant developments in the field, prompting a reevaluation of established criteria and resulting in expanded indications for CI. The chronological evolution of contraindications underscores the transformative nature of the field, offering potential improvements in outcomes and enhancing the quality of life for individuals with profound hearing loss. In conclusion, this narrative review emphasizes the dynamic nature of the field, where the reevaluation of contraindications has created new opportunities and broader indications for CI. The emerging prospects, including improved outcomes and enhanced quality of life, hold promise for individuals with profound hearing loss.
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Affiliation(s)
- Nezar Hamed
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box 245, Riyadh 11411, Saudi Arabia; (N.A.); (F.I.A.); (Y.A.A.); (A.A.); (R.I.A.)
| | - Norah Alajmi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box 245, Riyadh 11411, Saudi Arabia; (N.A.); (F.I.A.); (Y.A.A.); (A.A.); (R.I.A.)
| | - Faisal Ibrahim Alkoblan
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box 245, Riyadh 11411, Saudi Arabia; (N.A.); (F.I.A.); (Y.A.A.); (A.A.); (R.I.A.)
| | - Yazeed Abdullah Alghtani
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box 245, Riyadh 11411, Saudi Arabia; (N.A.); (F.I.A.); (Y.A.A.); (A.A.); (R.I.A.)
| | - Yassin Abdelsamad
- Research Department, MED-EL GmbH, P.O. Box 245, Riyadh 11411, Saudi Arabia;
| | - Ahmed Alhussien
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box 245, Riyadh 11411, Saudi Arabia; (N.A.); (F.I.A.); (Y.A.A.); (A.A.); (R.I.A.)
| | - Rafeef Ibrahim Alhajress
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box 245, Riyadh 11411, Saudi Arabia; (N.A.); (F.I.A.); (Y.A.A.); (A.A.); (R.I.A.)
| | - Salman F. Alhabib
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box 245, Riyadh 11411, Saudi Arabia; (N.A.); (F.I.A.); (Y.A.A.); (A.A.); (R.I.A.)
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Lee AY, Lee DY, Saunders JE. Preoperative Imaging in Cochlear Implants. Otol Neurotol 2024; 45:398-403. [PMID: 38478408 DOI: 10.1097/mao.0000000000004157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
OBJECTIVE To determine the utility of computed tomography (CT) and magnetic resonance imaging (MRI) in cochlear implant candidates. STUDY DESIGN Retrospective case review. SETTING Tertiary referral hospital. PATIENTS A total of 207 cochlear implanted patients with CT and/or MRI. INTERVENTIONS N/A. MAIN OUTCOME MEASURES Age versus abnormal radiologic findings, imaging abnormality versus postoperative outcomes, postoperative outcomes versus electrode design, Cambridge Cochlear Implant Protocol (CCIP) status for imaging abnormalities, sensitivity and specificity of CT and MRI for round-window/cochlear occlusion, and MRI for incomplete partitions. RESULTS A total of 207 patients with CT, MRI, or both were reviewed retrospectively. Less than half (15.5%) of CT scans had findings that might affect surgical intervention compared with 5.9% of MRI. No significant difference was found between children and adults for relevant imaging abnormalities (grade 4 or higher) with either CT (p = 0.931) or MRI (p = 0.606). CCIP status correlated with cochlear abnormalities (p = 0.040); however, only 46.2% of radiographic abnormalities on CT would be identified by these criteria. For detecting cochlear occlusion requiring surgical intervention, the sensitivity and specificity for CT were 40% (4 of 10; 95% confidence interval [CI], 12.16-73.76) and 95.73% (95% CI, 91.40-98.27), respectively. For MRI, the sensitivity and specificity were 33.33% (1 of 3; 95% CI, 0.84-90.57) and 96.97% (63 of 65; 95% CI, 89.32-99.63), respectively. There was no difference for postoperative AzBio scores for higher-grade imaging abnormalities (p = 0.6012) or for electrode designs (p = 0.3699). CONCLUSIONS Significant radiographic abnormalities were relatively uncommon in cochlear implant patients on either CT or MRI at our single-center institution. If present, abnormal imaging findings rarely translated to management changes. CCIP status does not reliably predict which patients are likely to have abnormalities. Both MRI and CT have low sensitivity for round-window or cochlear occlusion, but detection likely leads to changes in surgical management.
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Affiliation(s)
- Andrew Y Lee
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Diana Y Lee
- New York University Langone Health, Towson, Maryland
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McDaniel J, Krimm H, Schuele CM. SLPs' perceptions of language learning myths about children who are DHH. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024; 29:245-257. [PMID: 37742092 PMCID: PMC10950421 DOI: 10.1093/deafed/enad043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 06/30/2023] [Accepted: 08/23/2023] [Indexed: 09/25/2023]
Abstract
This article reports on speech-language pathologists' (SLPs') knowledge related to myths about spoken language learning of children who are deaf and hard of hearing (DHH). The broader study was designed as a step toward narrowing the research-practice gap and providing effective, evidence-based language services to children. In the broader study, SLPs (n = 106) reported their agreement/disagreement with myth statements and true statements (n = 52) about 7 clinical topics related to speech and language development. For the current report, participant responses to 7 statements within the DHH topic were analyzed. Participants exhibited a relative strength in bilingualism knowledge for spoken languages and a relative weakness in audiovisual integration knowledge. Much individual variation was observed. Participants' responses were more likely to align with current evidence about bilingualism if the participants had less experience as an SLP. The findings provide guidance on prioritizing topics for speech-language pathology preservice and professional development.
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Affiliation(s)
- Jena McDaniel
- Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine, Nashville, United States
| | - Hannah Krimm
- Department of Communication Sciences and Special Education, University of Georgia, Athens, United States
| | - C Melanie Schuele
- Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine, Nashville, United States
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Illg A, Adams D, Lesinski-Schiedat A, Lenarz T, Kral A. Variability in Receptive Language Development Following Bilateral Cochlear Implantation. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:618-632. [PMID: 38198368 DOI: 10.1044/2023_jslhr-23-00297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVES The primary aim was to investigate the variability in language development in children aged 5-7.5 years after bilateral cochlear implantation (CI) up to the age of 2 years, and any impact of the age at implantation and additional noncognitive or anatomical disorders at implantation. DESIGN Data of 84 congenitally deaf children that had received simultaneous bilateral CI at the age of ≤ 24 months were included in this retrospective study. The results of language comprehension acquisition were evaluated using a standardized German language acquisition test for normal hearing preschoolers and first graders. Data on speech perception of monosyllables and sentences in quiet and noise were added. RESULTS In a monosyllabic test, the children achieved a median performance of 75.0 ± 12.88%. In the sentence test in quiet, the median performance was 89 ± 12.69%, but dropped to 54 ± 18.92% in noise. A simple analysis showed a significant main effect of age at implantation on monosyllabic word comprehension (p < .001), but no significant effect of comorbidities that lacked cognitive effects (p = .24). Language acquisition values correspond to the normal range of children with normal hearing. Approximately 25% of the variability in the language acquisition tests is due to the outcome of the monosyllabic speech perception test. CONCLUSIONS Congenitally deaf children who were fitted bilaterally in the 1st year of life can develop age-appropriate language skills by the time they start school. The high variability in the data is partly due to the age of implantation, but additional factors such as cognitive factors (e.g., working memory) are likely to influence the variability.
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Affiliation(s)
- Angelika Illg
- Department of Otolaryngology, Medical University Hannover, Germany
| | - Doris Adams
- Department of Otolaryngology, Medical University Hannover, Germany
| | | | - Thomas Lenarz
- Department of Otolaryngology, Medical University Hannover, Germany
| | - Andrej Kral
- Department of Otolaryngology, Medical University Hannover, Germany
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Aggarwal K, Ravi R, Yerraguntla K. Impact of Hearing Loss on Social Participation in Children: A Scoping Review. Indian J Otolaryngol Head Neck Surg 2024; 76:804-810. [PMID: 38440490 PMCID: PMC10908891 DOI: 10.1007/s12070-023-04284-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 10/12/2023] [Indexed: 03/06/2024] Open
Abstract
Social participation can be defined as involvement in activities that provide a platform to interact with society and others. Untreated hearing loss effects communication skills, academic achievements, and peer-group interaction. Since a typical body structure and body functioning are essential to demonstrate day to day activities. Altogether these factors can influence the social participation in children with HL. The aim of this study is to systematically review the impact of hearing loss on social participation in children.A literature search was carried out to obtain studies exploring social participation among children with HL. Two authors independently searched four electronic databases, PubMed, Scopus, Embase, and Web of Science. The search strategy was designed by using six main terms 'social participation', 'social engagement', 'social interaction', 'hearing loss', 'hearing impairment', 'hearing disorder', and Boolean operators 'AND', 'OR' were used to make the search strings. The current review included four studies after meeting the eligibility criteria. Findings showed that social participation is affected in children with HL. Reduced hearing ability is one of the factors of reduced social participation in children. Children using hearing aids or cochlear implants, participate more frequently in social activities. The findings of this review suggest that HL is associated with reduced social participation. However, using hearing aids and cochlear implants followed by auditory verbal therapy has significant improvement in social participation. Future studies need to investigate whether early rehabilitation can increase social participation in children.
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Affiliation(s)
- Komal Aggarwal
- Department of Audiology and Speech-Language Pathology, Amity Medical School, Amity University, Gurugram, Haryana India
| | - Rohit Ravi
- Department of Audiology & Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka India
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Everhardt MK, Jung DE, Stiensma B, Lowie W, Başkent D, Sarampalis A. Foreign Language Acquisition in Adolescent Cochlear Implant Users. Ear Hear 2024; 45:174-185. [PMID: 37747307 PMCID: PMC10718217 DOI: 10.1097/aud.0000000000001410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 06/20/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVES This study explores to what degree adolescent cochlear implant (CI) users can learn a foreign language in a school setting similar to their normal-hearing (NH) peers despite the degraded auditory input. DESIGN A group of native Dutch adolescent CI users (age range 13 to 17 years) learning English as a foreign language at secondary school and a group of NH controls (age range 12 to 15 years) were assessed on their Dutch and English language skills using various language tasks that either relied on the processing of auditory information (i.e., listening task) or on the processing of orthographic information (i.e., reading and/or gap-fill task). The test battery also included various auditory and cognitive tasks to assess whether the auditory and cognitive functioning of the learners could explain the potential variation in language skills. RESULTS Results showed that adolescent CI users can learn English as a foreign language, as the English language skills of the CI users and their NH peers were comparable when assessed with reading or gap-fill tasks. However, the performance of the adolescent CI users was lower for English listening tasks. This discrepancy between task performance was not observed in their native language Dutch. The auditory tasks confirmed that the adolescent CI users had coarser temporal and spectral resolution than their NH peers, supporting the notion that the difference in foreign language listening skills may be due to a difference in auditory functioning. No differences in the cognitive functioning of the CI users and their NH peers were found that could explain the variation in the foreign language listening tasks. CONCLUSIONS In short, acquiring a foreign language with degraded auditory input appears to affect foreign language listening skills, yet does not appear to impact foreign language skills when assessed with tasks that rely on the processing of orthographic information. CI users could take advantage of orthographic information to facilitate foreign language acquisition and potentially support the development of listening-based foreign language skills.
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Affiliation(s)
- Marita K. Everhardt
- Center for Language and Cognition Groningen, University of Groningen, Netherlands
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
| | - Dorit Enja Jung
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
- Department of Psychology, University of Groningen, Netherlands
| | - Berrit Stiensma
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
| | - Wander Lowie
- Center for Language and Cognition Groningen, University of Groningen, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
| | - Deniz Başkent
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
- W.J. Kolff Institute for Biomedical Engineering and Materials Science, University Medical Center Groningen, University of Groningen, Netherlands
| | - Anastasios Sarampalis
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Netherlands
- Department of Psychology, University of Groningen, Netherlands
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Muller L, Goh BS, Cordovés AP, Sargsyan G, Sikka K, Singh S, Qiu J, Xu L, Graham PL, James CJ, Greenham P. Longitudinal outcomes for educational placement and quality of life in a prospectively recruited multinational cohort of children with cochlear implants. Int J Pediatr Otorhinolaryngol 2023; 170:111583. [PMID: 37245391 DOI: 10.1016/j.ijporl.2023.111583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/30/2023] [Accepted: 04/29/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVES The aim of this study was to report on the educational placement, quality of life and speech reception changes in a prospectively recruited group of children after they received a cochlear implant (CI). METHOD Data was collected on 1085 CI recipients of as part of a prospective, longitudinal, observational, international, multi-centre, paediatric registry, initiated by Cochlear Ltd (Sydney, NSW, Australia). Outcome data from children (≤10 years old) implanted in routine practice was voluntarily entered into a central, externally hosted, e-platform. Collection occurred prior to initial device activation (baseline) and at six monthly follow-up intervals up to 24 months and then at 3 years post activation. Clinician reported baseline and follow up questionnaires and Categories of Auditory Performance version II (CAP-II) outcomes were collated. Self-reported evaluation forms and patient information were provided by the parent/caregiver/patient via the implant recipient baseline and follow up, Children Using Hearing Implants Quality of Life (CuHIQoL) and Speech Spatial Qualities (SSQ-P) Parents Version questionnaires. RESULTS Children were mainly bilaterally profoundly deaf, unilaterally implanted and used a contralateral hearing aid. Prior to implant 60% used signing or total communication as their main mode of communication. Mean age at implant was 3.2 ± 2.2 years (range 0-10 years). At baseline 8.6% were in mainstream education with no additional support and 82% had not yet entered school. After three years of implant use, 52% had entered mainstream education with no additional support and 38% had not yet entered school. In the sub-group of 141 children who were implanted at or after three years of age and were thus old enough to be in mainstream school at the three-year follow up, an even higher proportion (73%) were in mainstream education with no support. Quality of life scores for the child improved statistically significantly post implant compared to baseline and continued to improve significantly at each interval up to 3 years (p < 0.001). Parental expectation scores reduced statistically significantly from baseline compared to all intervals (p < 0.028) and then increased significantly at 3 years compared to all post baseline follow-up intervals (p < 0.006). The impact on family life was reduced post implant compared to baseline and continued to reduce between annual intervals (p < 0.001). At three years post follow up median CAP II scores were 7 (IQR 6-7) and mean SSQ-P scores were 6.8 (SD1.9) 6.0 (SD1.9) and 7.4 (SD 2.3) for speech spatial and qualities scales respectively. SSQ-P and CAP II scores improved statistically and clinically significantly compared to baseline by one year post implantation. CAP II scores continued to improve at each test interval up to three years post implant. Speech and Qualities scores improved significantly between years 1 and 2 (p < 0.001), but only the Speech scores improved significantly between years 2 and 3 (p = 0.004). CONCLUSIONS Mainstream educational placement was achievable for most of the children, including those implanted at an older age. Quality of life for the child and the wider family improved. Future research could focus on the impact of mainstream school placement on children's academic progress, including measures of academic attainment and social functioning.
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Affiliation(s)
- Lida Muller
- Tygerberg Cochlear Implant Programme, South Africa.
| | - Bee See Goh
- University Kebangsaan Malaysia (UKM), Malaysia.
| | | | | | - Kapil Sikka
- All India Institute of Medical Sciences, New Delhi, India.
| | | | - Jianxin Qiu
- The First Affiliated Hospital of Anhui Medical University, China.
| | - Lei Xu
- Shandong Second Provincial General Hospital, China.
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León Méndez MDC, Fernández García L, Daza González MT. Effectiveness of rhythmic training on linguistics skill development in deaf children and adolescents with cochlear implants: A systematic review. Int J Pediatr Otorhinolaryngol 2023; 169:111561. [PMID: 37088038 DOI: 10.1016/j.ijporl.2023.111561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVE This review compiles the scientific evidence to date on the effectiveness of musical/rhythmic training for improving and/or enhancing the development of language skills in deaf children aged 6-16 years with cochlear implants. METHODS PubMed, ScienceDirect, and Web of Science were used for the research following the PRISMA protocol. RESULTS The reviewed studies indicate that rhythmic training can improve language skills (perception, production, and comprehension) in this population, as well as in other cognitive skills. CONCLUSION Although further research is still needed, the current evidence can help identify new and more effective early intervention methods for deaf children.
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Affiliation(s)
| | - Laura Fernández García
- Department of Psychology, University of Almería, Almería, Spain; Center for Neuropsychological Assessment and Rehabilitation (CERNEP), University of Almería, Almería, Spain
| | - María Teresa Daza González
- Department of Psychology, University of Almería, Almería, Spain; Center for Neuropsychological Assessment and Rehabilitation (CERNEP), University of Almería, Almería, Spain.
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Klieve S, Eadie P, Graham L, Leitão S. Complex Language Use in Children With Hearing Loss: A Scoping Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:688-719. [PMID: 36758198 DOI: 10.1044/2022_jslhr-22-00270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE Understanding what is known about the language profiles of children with hearing loss (CHL) is vital so that researchers and teachers can identify the specific complex syntactic structures that CHL may struggle to master. An understanding of which aspects of complex syntax pose difficulties for CHL is necessary to inform the kind of intervention that will facilitate learning complex syntax for this cohort of children. This scoping review aims to identify what is currently known about the complex syntax use of CHL who communicate through spoken language, and uncover gaps in the literature to guide further research. METHOD Ascoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. The Covidence software was utilized to manage the initial and full-text screening process for the search. RESULTS From a total of 304 studies, 42 studies were identified that met the eligibility criteria. The review highlights the use of broad-based language assessments and limited use of specific descriptions of the types of complex syntactic structures and skills. CONCLUSIONS Findings highlight the need for assessment protocols and analysis methods that better support the description of complex syntax profiles for CHL. School-age CHL continue to display challenges with complex syntax development. The review highlighted the need for further research to improve understanding of the complex syntax strengths and vulnerabilities of CHL. Further investigation is needed to better understand their ability to combine ideas and build complexity in their language use, which in turn can inform teaching in schools and interventions for children who require support. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21980177.
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Affiliation(s)
- Sharon Klieve
- Melbourne Graduate School of Education, University of Melbourne, Victoria, Australia
| | - Patricia Eadie
- Melbourne Graduate School of Education, University of Melbourne, Victoria, Australia
| | - Lorraine Graham
- Melbourne Graduate School of Education, University of Melbourne, Victoria, Australia
| | - Suze Leitão
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
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13
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Huber M. Cochlear implant-specific risks should be considered, when assessing the quality of life of children and adolescents with hearing loss and cochlear implants–not just cochlear implant-specific benefits–Perspective. Front Neurosci 2022; 16:985230. [DOI: 10.3389/fnins.2022.985230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 10/14/2022] [Indexed: 11/10/2022] Open
Abstract
Cochlear implants (CIs) are electronic medical devices that enable hearing in cases where traditional hearing aids are of minimal or no use. Quality of life (QoL) studies of children and adolescents with a CI have so far focused on the CI-specific benefits. However, the CI-specific risks listed by the U.S. Food and Drug Administration have not yet been considered. From this list, medical and device-related complications, lifelong dependency on the implanted device, and neurosecurity risks (CI technology is an interface technology) may be particularly relevant for young CI users. Medical and device-related complications can cause physical discomfort (e.g., fever, pain), as well as functioning problems (e.g., in speech discrimination, social behavior, and mood). In the worst case, reimplantation is required. Clinical experience shows that these complications are perceived as a burden for young CI users. Furthermore, many young patients are worried about possible complications. Additionally, CIs can be at least a temporary burden when children, typically at the age of 8–9 years, realize that they need the CI for life, or when they become peer victims because of their CI. Concerning neurosecurity risks, it is still unknown how young CI recipients perceive them. In summary, CI-specific risks can be perceived as a burden by young CI users that impairs their QoL. Therefore, they should not be ignored. There is an urgent need for studies on this topic, which would not only be important for professionals and parents, but also for the design of CI-specific QoL instruments.
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14
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Culbertson SR, Dillon MT, Richter ME, Brown KD, Anderson MR, Hancock SL, Park LR. Younger Age at Cochlear Implant Activation Results in Improved Auditory Skill Development for Children With Congenital Deafness. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3539-3547. [PMID: 36001854 PMCID: PMC9913281 DOI: 10.1044/2022_jslhr-22-00039] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/27/2022] [Accepted: 06/04/2022] [Indexed: 06/01/2023]
Abstract
PURPOSE The U.S. Food and Drug Administration indications for cochlear implantation in children is currently 9 months of age and older for children with bilateral profound sensorineural hearing loss (SNHL). Studies have shown that earlier activation of a cochlear implant (CI) can lead to better spoken language outcomes. As auditory skills are a precursor to the development of spoken language, this study was developed to investigate the influence of age at CI activation on auditory skill acquisition in young children. A secondary aim was to describe the auditory skills of children implanted prior to 9 months of age as compared to children with older ages of activation. METHOD Functional Listening Index (FLI) scores obtained during routine clinical visits were reviewed for 78 pediatric CI recipients with congenital bilateral profound hearing loss who were activated before 2 years of age. A linear mixed-effects model assessed the effect of age at CI activation on cumulative FLI scores over time. RESULTS There was a significant interaction between age at activation and chronological age at the time of evaluation, indicating that children with earlier access to sound achieved a greater number of auditory skills than those with later CI activations when measured at the same chronological age. Children activated before the age of 9 months approximated scores expected of children with typical hearing, whereas children activated between 9 and 24 months of age did not. CONCLUSIONS Younger age at CI activation is associated with increased auditory skills over time. Children who undergo cochlear implantation and CI activation before 9 months achieve more auditory skills by 4 years of age than children who are activated at later ages. These data suggest that reducing the approved age at cochlear implantation for children with congenital bilateral profound SNHL may support optimal auditory skill acquisition.
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Affiliation(s)
- Shannon R. Culbertson
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill
| | - Margaret T. Dillon
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Margaret E. Richter
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Kevin D. Brown
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Melissa R. Anderson
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Sandra L. Hancock
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
| | - Lisa R. Park
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill
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15
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Merchán A, Fernández García L, Gioiosa Maurno N, Ruiz Castañeda P, Daza González MT. Executive functions in deaf and hearing children: The mediating role of language skills in inhibitory control. J Exp Child Psychol 2022; 218:105374. [DOI: 10.1016/j.jecp.2022.105374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 11/16/2022]
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Li G, Zhao F, Tao Y, Zhang L, Zheng Y. Trajectories of receptive and expressive vocabulary in Mandarin speaking children under 4 years of age fitted with cochlear implants: a 12-month longitudinal study. Int J Audiol 2022:1-9. [PMID: 35608224 DOI: 10.1080/14992027.2022.2071769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To explore trajectories of receptive and expressive vocabulary in Mandarin-speaking children under the age of 4 years, fitted with cochlear implants (CIs). DESIGN Vocabulary trajectories were measured at baseline, 3, 6, and 12 months after implantation using the Chinese version of the MacArthur-Bates Communicative Development Inventory. STUDY SAMPLE There were 216 children with CIs in West China Hospital who took part and were divided into three groups based on age at first CI. RESULTS Receptive and expressive vocabulary scores of the younger implantation group were significantly different from the older groups at baseline. After 12 months of implant use, there were no significant differences between all groups. Furthermore receptive vocabulary trajectories for all children with CIs were not significantly different from those of children with normal hearing. However, expressive vocabulary trajectories were poorer when compared to children with normal hearing. Significant differences were seen between receptive and expressive vocabulary in all age groups. CONCLUSIONS This study suggests no differences in vocabulary trajectories in Mandarin-speaking children whether they received their first CI at 1, 2, or 3 years of age. It is important that clinicians convey realistic expectations about potential differences in receptive vs. expressive trajectories for Mandarin-speaking children fitted with CIs.
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Affiliation(s)
- Gang Li
- Hearing Center/Hearing & Speech Science Laboratory, Department of Otolaryngology/Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Fei Zhao
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Yong Tao
- Hearing Center/Hearing & Speech Science Laboratory, Department of Otolaryngology/Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Lin Zhang
- Hearing Center/Hearing & Speech Science Laboratory, Department of Otolaryngology/Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Yun Zheng
- Hearing Center/Hearing & Speech Science Laboratory, Department of Otolaryngology/Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
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17
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Busch T, Brinchmann EI, Braeken J, Wie OB. Receptive Vocabulary of Children With Bilateral Cochlear Implants From 3 to 16 Years of Age. Ear Hear 2022; 43:1866-1880. [PMID: 35426854 PMCID: PMC9592181 DOI: 10.1097/aud.0000000000001220] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The vocabulary of children with cochlear implants is often smaller than that of their peers with typical hearing, but there is uncertainty regarding the extent of the differences and potential risks and protective factors. Some studies indicate that their receptive vocabulary develops well at first, but that they fail to keep up with their typical hearing peers, causing many CI users to enter school with a receptive vocabulary that is not age-appropriate. To better understand the receptive vocabulary abilities of children with cochlear implants this study explored age-related differences to matched children with typical hearing and associations between vocabulary skills and child-level characteristics. DESIGN A retrospective cross-sectional study with matched controls was conducted at the Norwegian national cochlear implant center at Oslo University Hospital. Eighty-eight children (mean age 8.7 years; range 3.2 to 15.9; 43 girls, 45 boys) who had received bilateral cochlear implants before 3 years of age were compared with two groups of children with typical hearing. One group was matched for maternal education, sex, and chronological age, the other group was matched for maternal education, sex, and hearing age. Receptive vocabulary performance was measured with the British Picture Vocabulary Scale. RESULTS Cochlear implant users' receptive vocabulary was poorer than that of age-matched children with typical hearing ( M = 84.6 standard points, SD = 21.1; children with typical hearing: M = 102.1 standard points, SD = 15.8; mean difference -17.5 standard points, 95% CI [-23.0 to -12.0], p < 0.001; Hedges's g = -0.94, 95% CI [-1.24 to -0.62]), and children with cochlear implants were significantly more likely to perform below the normative range (risk ratio = 2.2, 95% CI [1.42 to 3.83]). However, there was a significant nonlinear U-shaped effect of age on the scores of cochlear implant users, with the difference to the matched typical hearing children being largest (23.9 standard points, on average) around 8.7 years of age and smaller toward the beginning and end of the age range. There was no significant difference compared with children with typical hearing when differences in auditory experience were accounted for. Variability was not significantly different between the groups. Further analysis with a random forest revealed that, in addition to chronological age and hearing age, simultaneous versus sequential implantation, communication mode at school, and social integration were predictors of cochlear implant users' receptive vocabulary. CONCLUSIONS On average, the receptive vocabulary of children with cochlear implants was smaller than that of their typical hearing peers. The magnitude of the difference was changing with age and was the largest for children in early primary school. The nonlinear effect of age might explain some of the ambiguity in previous research findings and could indicate that better intervention is required around school entry. The results emphasize that continuous monitoring and support are crucial to avoid far-reaching negative effects on the children's development and well-being.
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Affiliation(s)
- Tobias Busch
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | | | - Johan Braeken
- Centre for Educational Measurement, University of Oslo, Oslo, Norway
| | - Ona Bø Wie
- Department of Special Needs Education, University of Oslo, Oslo, Norway,Department of Otolaryngology, Oslo University Hospital, Oslo, Norway
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18
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Freitas E, Simões C, Santos AC, Mineiro A. Resilience in deaf children: A comprehensive literature review and applications for school staff. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:1198-1223. [PMID: 34643946 DOI: 10.1002/jcop.22730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 08/06/2021] [Accepted: 09/16/2021] [Indexed: 06/13/2023]
Abstract
Resilience is a dynamic, multidimensional complex concept that implies risk and protective factors, adaptation, and success. Communication and language are often identified as barriers in deaf children's development. However, research linking deafness in childhood and resilience is scarce. The present comprehensive literature review aims to verify which are the predominant risk factors for this group, which protective factors may be identified and if significant differences have been found between deaf and hearing children regarding resilience. A systematic search, performed in seven databases, identified 11 articles published in peer-reviewed journals between 2000 and 2019 that met the criteria. Deaf children experience exposure to risk through obstacles in communication, language, and information failure. Consequently, differences between hearing and deaf children are related to more difficulties in emotion regulation and interpersonal relationships. Principal protective factors are a supportive family, school staff, and peers. Practical implications and recommendations for future research are provided.
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Affiliation(s)
- Eunice Freitas
- Departamento de Educação, Ciências Sociais e Humanidades, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Celeste Simões
- Departamento de Educação, Ciências Sociais e Humanidades, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
- Aventura Social, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Anabela C Santos
- Departamento de Educação, Ciências Sociais e Humanidades, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
- Aventura Social, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- ISCTE - Instituto Universitário de Lisboa (IUL), CIS-IUL, Lisboa, Portugal
| | - Ana Mineiro
- Instituto de Ciências Sociais, Centro de Investigação Interdisciplinar em Saúde (CIIS), Universidade Católica Portuguesa, Lisboa, Portugal
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19
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Piromchai P, Tanamai N, Kiatthanabumrung S, Kaewsiri S, Thongyai K, Atchariyasathian V, Thanawirattananit P, Wacharasindhu C, Mukkun T, Isipradit P, Yimtae K. Multicentre cohort study of cochlear implantation outcomes in Thailand. BMJ Open 2021; 11:e054041. [PMID: 34845075 PMCID: PMC8634017 DOI: 10.1136/bmjopen-2021-054041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To report the status and outcomes of cochlear implantation in Thailand. DESIGN Cohort study. SETTING Tertiary care and university hospitals. PARTICIPANTS Patients who underwent cochlear implant surgery in Thailand. INTERVENTIONS This project collected data from all government and university hospitals in Thailand where cochlear implant surgery was performed between 2016 and 2020. PRIMARY AND SECONDARY OUTCOME MEASURES Baseline characteristics, operation data, complications, audiological outcomes and quality of life were reported. RESULTS This study included 458 patients, and nearly half of the patients were children and adolescents (46.94%). The mean age of the patients was 2.96±5.83 years. At 1 year postoperatively, the mean pure tone average of the hearing threshold in the implanted ear significantly improved from unaided preoperative baseline (mean difference (MD) 64.23 dB HL; 95% CI 59.81 to 68.65; p<0.001). The mean speech recognition threshold also improved (MD 55.96 dB HL; 95% CI 49.50 to 62.42, p<0.001). The quality-of-life scores of the EQ-5D-5L, PedsQL and HUI3 questionnaires at 1 year showed improved mobility (range, 0-5; MD 0.65; 95% CI 0.05 to 1.25; p=0.037), hearing (range, 0-6; MD 0.96; 95% CI 0.30 to 1.61; p=0.006) and speech (range, 0-5; MD 0.44; 95% CI 0.04 to 0.84; p=0.031). Common complications included electrode dislodgement (2.18%), vertigo (1.23%) and meningitis (1.93%). CONCLUSIONS Excellent audiological outcomes and improvement in the quality of life in the mobility, hearing and speech domains were observed in patients who underwent cochlear implantation in Thailand.
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Affiliation(s)
- Patorn Piromchai
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Khon Kaen Ear, Hearing and Balance Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Napas Tanamai
- Center of Excellence in Otolaryngology, Head & Neck Surgery, Rajavithi Hospital, Bangkok, Thailand
| | - Sivaporn Kiatthanabumrung
- Department of Otolaryngology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suwicha Kaewsiri
- Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kanthong Thongyai
- Department of Otolaryngology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Panida Thanawirattananit
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Khon Kaen Ear, Hearing and Balance Research Group, Khon Kaen University, Khon Kaen, Thailand
| | | | - Tulakan Mukkun
- Department of Otolaryngology, Trang Hospital, Trang, Thailand
| | - Permsarp Isipradit
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kwanchanok Yimtae
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Khon Kaen Ear, Hearing and Balance Research Group, Khon Kaen University, Khon Kaen, Thailand
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20
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Pluta A, Krysztofiak M, Zgoda M, Wysocka J, Golec K, Wójcik J, Włodarczyk E, Haman M. False Belief Understanding in Deaf Children With Cochlear Implants. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2021; 26:511-521. [PMID: 34179946 PMCID: PMC8448438 DOI: 10.1093/deafed/enab015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 04/28/2021] [Accepted: 05/08/2021] [Indexed: 05/31/2023]
Abstract
Theory of mind (ToM) is crucial for social interactions. Previous research has indicated that deaf and hard-of-hearing children born into hearing families (DoH) are at risk of delayed ToM development. However, it is unclear whether this is the case for DoH children who receive cochlear implants (CIs) before and around the second year of life. The present study aimed to investigate false belief understanding (FBU) in DoH children with CIs. The relationships between false belief task (FBT) performance, sentence comprehension, age at implantation, duration of CI use, and Speech Recognition Threshold were explored. A total of 94 children with typical levels of hearing (TH) and 45 DoH children (age range: 3-8), who received their first CI between 6 and 27 months of age, were tested on the FBT and a sentence comprehension test. Results showed that 4- and 5-year-old children with CIs performed significantly worse than their peers with TH on the FBT; 6- to 8-year-old children with CIs performed similarly to age-matched children with TH. Age at implantation and duration of CI use were correlated with sentence comprehension but not with the FBT. The results indicated that FBU was delayed until the age of 6 years in most of children with CIs.
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Affiliation(s)
- Agnieszka Pluta
- Correspondence should be addressed to Agnieszka Pluta, Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183 Warsaw, Poland. E-mail:
| | | | - Małgorzata Zgoda
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw, Poland
| | - Joanna Wysocka
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Karolina Golec
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Joanna Wójcik
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw, Poland
| | - Elżbieta Włodarczyk
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Warsaw, Poland
| | - Maciej Haman
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
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21
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Miyoshi T, Belyantseva IA, Kitajiri SI, Miyajima H, Nishio SY, Usami SI, Kim BJ, Choi BY, Omori K, Shroff H, Friedman TB. Human deafness-associated variants alter the dynamics of key molecules in hair cell stereocilia F-actin cores. Hum Genet 2021; 141:363-382. [PMID: 34232383 DOI: 10.1007/s00439-021-02304-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/15/2021] [Indexed: 12/16/2022]
Abstract
Stereocilia protrude up to 100 µm from the apical surface of vertebrate inner ear hair cells and are packed with cross-linked filamentous actin (F-actin). They function as mechanical switches to convert sound vibration into electrochemical neuronal signals transmitted to the brain. Several genes encode molecular components of stereocilia including actin monomers, actin regulatory and bundling proteins, motor proteins and the proteins of the mechanotransduction complex. A stereocilium F-actin core is a dynamic system, which is continuously being remodeled while maintaining an outwardly stable architecture under the regulation of F-actin barbed-end cappers, severing proteins and crosslinkers. The F-actin cores of stereocilia also provide a pathway for motor proteins to transport cargos including components of tip-link densities, scaffolding proteins and actin regulatory proteins. Deficiencies and mutations of stereocilia components that disturb this "dynamic equilibrium" in stereocilia can induce morphological changes and disrupt mechanotransduction causing sensorineural hearing loss, best studied in mouse and zebrafish models. Currently, at least 23 genes, associated with human syndromic and nonsyndromic hearing loss, encode proteins involved in the development and maintenance of stereocilia F-actin cores. However, it is challenging to predict how variants associated with sensorineural hearing loss segregating in families affect protein function. Here, we review the functions of several molecular components of stereocilia F-actin cores and provide new data from our experimental approach to directly evaluate the pathogenicity and functional impact of reported and novel variants of DIAPH1 in autosomal-dominant DFNA1 hearing loss using single-molecule fluorescence microscopy.
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Affiliation(s)
- Takushi Miyoshi
- Laboratory of Molecular Genetics, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Porter Neuroscience Research Center, Room 1F-143A, Bethesda, MD, 20892, USA. .,Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan.
| | - Inna A Belyantseva
- Laboratory of Molecular Genetics, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Porter Neuroscience Research Center, Room 1F-143A, Bethesda, MD, 20892, USA
| | - Shin-Ichiro Kitajiri
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, 390-8621, Matsumoto, Japan
| | - Hiroki Miyajima
- Department of Otolaryngology, Shinshu University School of Medicine, Matsumoto, 390-8621, Japan.,Department of Otolaryngology, Aizawa Hospital, Matsumoto, 390-8510, Japan
| | - Shin-Ya Nishio
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, 390-8621, Matsumoto, Japan
| | - Shin-Ichi Usami
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, 390-8621, Matsumoto, Japan
| | - Bong Jik Kim
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Chungnam National University Sejong Hospital, Sejong, 30099, South Korea.,Brain Research Institute, Chungnam National University College of Medicine, Daejeon, 35015, South Korea
| | - Byung Yoon Choi
- Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seongnam, 13620, South Korea
| | - Koichi Omori
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Hari Shroff
- Laboratory of High Resolution Optical Imaging, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Thomas B Friedman
- Laboratory of Molecular Genetics, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Porter Neuroscience Research Center, Room 1F-143A, Bethesda, MD, 20892, USA
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22
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Abstract
Objectives: This longitudinal study followed the language development of children who received the combination of early (5 to 18 months) and simultaneous bilateral cochlear implants (CIs) throughout the first 6 years after implantation. It examined the trajectories of their language development and identified factors associated with language outcomes. Design: Participants were 21 Norwegian children who received bilateral CIs between the ages of 5 and 18 mo and 21 children with normal hearing (NH) who were matched to the children with CIs on age, sex, and maternal education. The language skills of these two groups were compared at 10 time points (3, 6, 9, 12, 18, 24, 36, 48, 60, and 72 months after implantation) using parent reports and standardized measures of general language skills, vocabulary, and grammar. In addition, assessments were made of the effects of age at CI activation, speech recognition abilities, and mothers’ education on language outcomes 6 years after implantation. Results: During the first 4 years after implantation, the gap in general expressive and receptive language abilities between children with CIs and children with NH gradually closed. While at the initial five to six assessments (3 to 36 months after implantation), significant differences between children with CIs and children with NH were observed; at 4 years after implantation, there were no longer any significant group differences in general language skills and most children with CIs achieved scores within 1 SD of the tests’ normative means. From 2 to 3 years after implantation onward, expressive vocabulary and receptive grammar skills of children with CIs were similar to those of the reference group. However, from 4 years after implantation until the end of the observation period, 6 years after implantation, expressive grammar skills of children with CIs were lower than those of children with NH. In addition, a gap in receptive vocabulary appeared and grew increasingly larger from 4 to 6 years postimplantation. At the final assessment, the children with CIs had an average receptive vocabulary score around 1 SD below the normative mean. Regression analysis indicated that the children’s language outcomes at 6 years after implantation were related to their speech recognition skills, age at CI activation, and maternal education. Conclusions: In the first 4 years after implantation, the language performance of children with CIs became increasingly similar to that of their NH peers. However, between 4 and 6 years after implantation, there were indications of challenges with certain aspects of language, specifically receptive vocabulary and expressive grammar. Because these challenges first appeared after the 4-year assessment, the findings underline the importance of long-term language intervention to increase the chances of a continued language development comparable to that of NH peers. They also indicate that there is a need for comprehensive longitudinal studies of the language development of children with CIs beyond 4 years after implantation.
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Hilviu D, Parola A, Vivaldo S, Di Lisi D, Consolino P, Bosco F. Children with hearing impairment and early cochlear implant: A pragmatic assessment. Heliyon 2021; 7:e07428. [PMID: 34286120 PMCID: PMC8273221 DOI: 10.1016/j.heliyon.2021.e07428] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/27/2021] [Accepted: 06/24/2021] [Indexed: 11/30/2022] Open
Abstract
Extensive research has demonstrated the benefits of cochlear implants (CI) in contributing to improve the linguistic skills of children with hearing impairment; however, few studies have focused on the development of pragmatic ability and its relationship with age of implantation. Pragmatics is the ability to use language in different contexts and its development has crucial implications, e.g., social inclusion and professional attainments. In this study, we conducted a comprehensive assessment of pragmatic ability using the Language Pragmatic Abilities (APL Medea), a battery composed by five different tasks: Comprehension of Metaphors, Implicit meaning, Comics, Situations and Colors Game (a perspective taking task). Eighteen children with early CI, belonging to 3 different age groups (6; 11-7; 11, 8; 0-8; 11 and 9; 0-9; 11 years-old), and twenty-four children with typical development (Control Group) participated to the study. We also investigated how the precocity of CI, i.e., age of first implantation, may affect the pragmatic development. Globally, children with CI obtained lower scores in the APL Medea battery than typically hearing children. However, focusing on the Medea tasks separately, children with CIs differed from their hearing peers only in Comics and Colors Game tasks. Finally, age of implantation was a moderate but significant predictor of pragmatic performance.
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Affiliation(s)
- D. Hilviu
- University of Turin, Department of Psychology, Group on Inferential Processes in Social Interaction (GIPSI), Turin, Italy
| | - A. Parola
- University of Turin, Department of Psychology, Group on Inferential Processes in Social Interaction (GIPSI), Turin, Italy
- Aarhus University, Department of Linguistics, Semiotics and Cognitive Science, Aarhus, Denmark
| | - S. Vivaldo
- Martini Hospital, ENT Department, Turin, Italy
| | - D. Di Lisi
- Martini Hospital, ENT Department, Turin, Italy
| | | | - F.M. Bosco
- University of Turin, Department of Psychology, Group on Inferential Processes in Social Interaction (GIPSI), Turin, Italy
- University of Turin, Neuroscience Institute of Turin, Turin, Italy
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Mayer C, Trezek BJ, Hancock GR. Reading Achievement of Deaf Students: Challenging the Fourth Grade Ceiling. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2021; 26:427-437. [PMID: 34060625 DOI: 10.1093/deafed/enab013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 06/12/2023]
Abstract
Historically it has been reported that deaf students do not achieve age-appropriate outcomes in reading, with this performance often being characterized in terms of a fourth grade ceiling. However, given the shifts in the field during the past 20 years (e.g., widespread implementation of newborn hearing screening, advances in hearing technologies), it would be timely to question whether this continues to serve as a meaningful benchmark. To this end, the purpose of this study was to investigate reading outcomes of a Canadian cohort of school-aged deaf learners (N = 70) who all used listening and spoken language as the primary mode of communication. Specifically, the goal was to establish whether their achievement approached that of their hearing age peers and to identify demographic factors influencing performance (i.e., gender, unilateral/bilateral hearing loss, personal amplification, level of auditory functioning, grade placement, additional disabilities, home language). Results indicate that participants obtained standard scores in the average range on both the Basic Reading and Reading Comprehension clusters of the Woodcock Johnson III-Diagnostic Reading Battery (Woodcock et al., 2004), surpassing the fourth grade reading achievement ceiling often reported for this population.
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Affiliation(s)
- Connie Mayer
- Faculty of Education, York University, Toronto, ON, Canada
| | - Beverly J Trezek
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, Madison, WI, USA
| | - Gregory R Hancock
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
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Dettman S, Choo D, Au A, Luu A, Dowell R. Speech Perception and Language Outcomes for Infants Receiving Cochlear Implants Before or After 9 Months of Age: Use of Category-Based Aggregation of Data in an Unselected Pediatric Cohort. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:1023-1039. [PMID: 33630667 DOI: 10.1044/2020_jslhr-20-00228] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose This retrospective study aimed to amass large data sets to enable statistical comparisons of communication outcomes for infants receiving cochlear implants (CIs) before 9 months of age compared to groups who received their first CI between 9 months and 3.5 years of age. Method Speech perception scores and experienced clinicians' observations were used to refine the Categories of Auditory Performance Index (CAPI), thus creating its revised version, namely, the CAPI-Revised (CAPI-R). Standardized and criterion-referenced language data were used to create the novel Categories of Linguistic Performance (CLIP). The association between CAPI-R and CLIP data at two time points post implant (at 2 years of device experience and at 5 years of age) was examined in a large unselected cohort stratified for age at first implant: before 9 months (Group 1), between 9 and 12 months (Group 2), between 13 and 18 months (Group 3), between 19 and 24 months (Group 4), between 25 and 30 months (Group 5), between 31 and 36 months (Group 6), and between 37 and 42 months (Group 7). Results CAPI-R medians were 5 at 2 years of device experience, and 6 at 5 years of age. At 2 years of device experience, there was no significant difference in CAPI-R medians for children who received their first CI before 9 months compared to all other age-at-implant groups. At 5 years of age, a significantly better CAPI-R median was demonstrated by Group 1 (CI before 9 months) compared to Groups 4, 5, 6, and 7. CLIP medians were 3 at 2 years of device experience, and at 5 years of age. At 2 years device experience, and at 5 years of age, the Group 1 CLIP medians were significantly better than later age-at-implant groups. Conclusion Median CAPI-R outcomes supported access to CIs before 18 months of age for speech perception, and median CLIP outcomes supported access to CIs before 9 months of age for optimum language development.
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Affiliation(s)
- Shani Dettman
- Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, Victoria, Australia
- The HEARing CRC, Carlton, Victoria, Australia
- Cochlear Implant Clinic, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Dawn Choo
- Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, Victoria, Australia
- The HEARing CRC, Carlton, Victoria, Australia
- Cochlear Implant Clinic, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Agnes Au
- Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, Victoria, Australia
| | - Amy Luu
- Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, Victoria, Australia
| | - Richard Dowell
- Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, Victoria, Australia
- The HEARing CRC, Carlton, Victoria, Australia
- Cochlear Implant Clinic, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
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Identifying barriers and considerations for cochlear implantation in Amish children. Am J Otolaryngol 2021; 42:102887. [PMID: 33422945 DOI: 10.1016/j.amjoto.2020.102887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/27/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To determine if barriers to cochlear implantation (CI) exist with respect to Amish children and to describe unique considerations associated with CI and subsequent otologic care in the Amish population. METHODS Out of all patients who underwent CI at a tertiary care pediatric hospital from 2008 to 2019, Amish children were age-matched to the remainder of the cohort to compare demographics and care-related metrics including etiology of hearing loss, age at time of initial hearing-related appointment and at CI, total number of pre- and post-operative audiologic and otologic appointments, and post-operative complications. Social considerations that may pose barriers to care were collected for descriptive analysis. RESULTS Since 2008, 232 children underwent CI, of which 8 implants were performed on Amish children. Six (75%) Amish children underwent newborn hearing screening and 3(38%) were found to have syndromic etiology for hearing loss. While Amish patients had a lower number of both audiologic (15 vs 33.5, p<.001) and otologic (4.5 vs 8.5, p=.028) appointments when compared to age-matched controls, median age at the time of implantation for the whole sample was not different between groups (2.5 vs 2.0 years, p=.211). From a social standpoint, limitations in transportation, telephone communication, and ability to recharge processor batteries must be considered in the Amish population. CONCLUSION Amish children undergoing CI face unique barriers to care including transportation and technologic limitations, leading to overall fewer hearing-related appointments when compared to an age-matched cohort. Understanding societal differences is important to facilitate optimal care for Amish children with hearing loss.
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Purcell PL, Deep NL, Waltzman SB, Roland JT, Cushing SL, Papsin BC, Gordon KA. Cochlear Implantation in Infants: Why and How. Trends Hear 2021; 25:23312165211031751. [PMID: 34281434 PMCID: PMC8295935 DOI: 10.1177/23312165211031751] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 04/22/2021] [Accepted: 06/23/2021] [Indexed: 11/25/2022] Open
Abstract
In children with congenital deafness, cochlear implantation (CI) prior to 12 months of age offers the opportunity to foster more typical auditory development during late infancy and early childhood. Recent studies have found a positive association between early implantation and expressive and receptive language outcomes, with some children able to achieve normal language skills by the time of school entry. Universal newborn hearing screening improved early detection and diagnosis of congenital hearing loss, allowing for earlier intervention, including decision-making regarding cochlear implant (CI) candidacy. It can be more challenging to confirm CI candidacy in infants; therefore, a multidisciplinary approach, including objective audiometric testing, is recommended to not only confirm the diagnosis but also to counsel families regarding expectations and long-term management. Surgeons performing CI surgery in young children should consider both the anesthetic risks of surgery in infancy and the ways in which mastoid anatomy may differ between infants and older children or adults. Multiple studies have found CI surgery in infants can be performed safely and effectively. This article reviews current evidence regarding indications for implantation in children younger than 12 months of age and discusses perioperative considerations and surgical technique.
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Affiliation(s)
- Patricia L. Purcell
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nicholas L. Deep
- Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States
| | - Susan B. Waltzman
- Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States
| | - J. Thomas Roland
- Department of Otolaryngology, Head & Neck Surgery, New York University Grossman School of Medicine, New York, New York, United States
| | - Sharon L. Cushing
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Blake C. Papsin
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen A. Gordon
- Department of Otolaryngology, Head & Neck Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
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Kumar V, Mehta R. Receptive and Expressive Language in Hindi Speaking Children with Postcochlear Implantation at 6-Month Intervals. Int Arch Otorhinolaryngol 2020; 25:e407-e412. [PMID: 34377176 PMCID: PMC8321638 DOI: 10.1055/s-0040-1716570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/21/2020] [Indexed: 11/12/2022] Open
Abstract
Introduction
Individual variability in the language outcomes of children with cochlear implantation (CI) is a major concern. In CI rehabilitation, there is lack of a protocol regarding uniform post-CI language assessment interval duration, which can ensure better understanding of the trajectory of language growth as well as optimize language outcomes by providing feedback in fine tuning the language intervention program.
Objective
To evaluate the receptive and expressive language in Hindi speaking children with up to 2 years of CI experience using revised receptive-expressive emergent language test-3ed. (REELT-3) at 6 months intervals and to compare it with that of children with normal hearing (NH).
Methods
The present study included 192 children divided in 2 groups, 96 children with CI (15.8 ± 6.7 months), and 96 age-matched children with NH (22.3 ± 7.9 months). A cross-sectional, prospective study design was used to measure the language ability score (LAS) at an interval of 6 months from the time of implantation (TIA), which is 0 to 6 months, 7 to 12 months, 13 to 18 months, and 19 to 24 months of CI usage.
Results
The two-way analysis of variance revealed that the LAS after 18 months of CI usage was similar to (F (3, 92) = 8.63,
p
= 0.19, ηp2 = 0.028) that of the children with NH. However, other demographic factors, for instance, gender (F (3, 92) = 1.73,
p
= 0.505, ηp2 = 0.002), parent's education, (F (3, 92) = 2.05,
p
= 0.937, ηp2 = 0.031), and financial background (F (3, 92) = 2.49,
p
= 0.351, ηp2 = 0.076) had no major impact on language.
Conclusion
Eighteen months of CI usage duration can potentially stimulate receptive and expressive language up to age-matched children with NH. A protocol of periodic assessment of language, at least of 6 months, may be developed to optimize language outcomes.
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Affiliation(s)
- Vijay Kumar
- Department of Audiology & Speech Language Pathology, Amity University Gurgaon, Haryana, India.,Amity Institute of Neuropsychology & Neurosceience, Amity University, Noida, Uttar Pradesh, India
| | - Rachna Mehta
- Amity Institute of Neuropsychology & Neurosceience, Amity University, Noida, Uttar Pradesh, India
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Pantelemon C, Necula V, Berghe AS, Livinț-Popa L, Palade S, Văcăraș V, Mureșanu IA, Strilciuc Ș, Mureșanu FD. Neurodevelopmental Aspects and Cortical Auditory Maturation in Children with Cochlear Implants. ACTA ACUST UNITED AC 2020; 56:medicina56070344. [PMID: 32668569 PMCID: PMC7404556 DOI: 10.3390/medicina56070344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 11/16/2022]
Abstract
Background and objectives: The cochlear implant is not only meant to restore auditory function, but it also has a series of benefits on the psychomotor development and on the maturation of central auditory pathways. In this study, with the help of neuropsychological tests and cortical auditory potentials (CAEPs), we intend to identify a series of instruments that allow us to monitor children with a cochlear implant, and later on, to admit them into an individualized rehabilitation program. Materials and methods: This is a longitudinal study containing 17 subjects (6 boys and 11 girls) diagnosed with congenital sensorineural hearing loss. The average age for cochlear implantation in our cohort is 22 months old. Each child was tested before the cochlear implantation, tested again 3 months after the implant, and then 6 months after the implant. To test the general development, we used the Denver Developmental Screening Test (DDST II). CAEPs were recorded to assess the maturation of central auditory pathways. Results: The results showed there was progress in both general development and language development, with a significant statistical difference between the overall DQ (developmental quotient) and language DQ before the cochlear implantation and three and six months later, respectively. Similarly, CAEP measurements revealed a decrease of positive-going component (P1) latency after cochlear implantation. Conclusion: CAEPs and neuropsychological tests prove to be useful instruments for monitoring the progress in patients with cochlear implants during the rehabilitation process.
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Affiliation(s)
- Cristina Pantelemon
- Department of Neurosciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400486 Cluj-Napoca, Romania; (C.P.); (L.L.-P.); (V.V.); (I.A.M.); (F.D.M.)
- “RoNeuro” Institute for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania
| | - Violeta Necula
- Department of ENT, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400486 Cluj-Napoca, Romania;
| | - Alexandra-Stefania Berghe
- Department of Medical Informatics and Biostatistics, “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania;
| | - Livia Livinț-Popa
- Department of Neurosciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400486 Cluj-Napoca, Romania; (C.P.); (L.L.-P.); (V.V.); (I.A.M.); (F.D.M.)
- “RoNeuro” Institute for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania
| | - Steluța Palade
- Department of Pediatric Neurology, Children’s Emergency Hospital Cluj-Napoca, 400378 Cluj-Napoca, Romania;
| | - Vitalie Văcăraș
- Department of Neurosciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400486 Cluj-Napoca, Romania; (C.P.); (L.L.-P.); (V.V.); (I.A.M.); (F.D.M.)
- “RoNeuro” Institute for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania
| | - Ioana Anamaria Mureșanu
- Department of Neurosciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400486 Cluj-Napoca, Romania; (C.P.); (L.L.-P.); (V.V.); (I.A.M.); (F.D.M.)
- “RoNeuro” Institute for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania
| | - Ștefan Strilciuc
- Department of Neurosciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400486 Cluj-Napoca, Romania; (C.P.); (L.L.-P.); (V.V.); (I.A.M.); (F.D.M.)
- “RoNeuro” Institute for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania
- Correspondence:
| | - Fior-Dafin Mureșanu
- Department of Neurosciences, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400486 Cluj-Napoca, Romania; (C.P.); (L.L.-P.); (V.V.); (I.A.M.); (F.D.M.)
- “RoNeuro” Institute for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania
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Yang Y, Chen M, Zheng J, Hao J, Liu B, Liu W, Li B, Shao J, Liu H, Ni X, Zhang J. Clinical evaluation of cochlear implantation in children younger than 12 months of age. Pediatr Investig 2020; 4:99-103. [PMID: 32851352 PMCID: PMC7331375 DOI: 10.1002/ped4.12202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 02/02/2020] [Indexed: 11/11/2022] Open
Abstract
IMPORTANCE Cochlear implantation (CI) is an effective therapy for patients with severe to profound sensorineural hearing loss. It remains controversial whether children younger than 12 months of age should undergo CI. OBJECTIVE To evaluate the safety and effectiveness of CI in children younger than 12 months of age. METHODS We performed a retrospective study of clinical data of pediatric patients younger than 12 months of age who underwent CI and were followed up for 1 to 2 years. Patients' developmental levels were evaluated by the Gesell score before CI. Intraoperative and postoperative complications were recorded to evaluate the safety of CI. Auditory and speech abilities were scored by the LittlEARS® auditory questionnaire (LEAQ), categories of auditory performance (CAP), speech intelligibility rating (SIR), infant-toddler meaningful auditory integration scale (IT-MAIS), and meaningful use of speech scale (MUSS) at 1, 2, 3, 6, 9, and 12 months after CI. The associations between clinical characteristics before CI and postoperative scores at 1 year after CI were analyzed by the linear mixed-effects model. RESULTS Eighty-nine children (47 boys and 42 girls) were included in this study (mean age at CI, 9.2 ± 1.6 months). Sixteen patients were diagnosed with cochlear malformation and 16 underwent bilateral CI. No severe complications occurred in any patients. The mean developmental quotient of the Gesell score was 78.00 ± 10.03. The median LEAQ scores were 0, 5, 10, 16, 22, 26 and 30 before and at 1, 2, 3, 6, 9, and 12 months after CI, respectively. These findings implied that the LEAQ score greatly improved in the first year after CI. The overall CAP, SIR, IT-MAIS, and MUSS scores also increased with increasing duration after CI. No significant associations were detected between clinical characteristics (age, sex, implant number, pre-CI Gesell score, and inner ear malformation) and LEAQ outcomes at 12 months after CI. INTERPRETATION With increasing duration after CI, auditory and speech behavior dramatically improve in young children. Our findings indicate that CI is feasible for children younger than 12 months of age.
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Affiliation(s)
- Yang Yang
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Min Chen
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Jun Zheng
- Beijing Tongren HospitalCapital Medical UniversityBeijingChina
| | - Jinsheng Hao
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Bing Liu
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Wei Liu
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Bei Li
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Jianbo Shao
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Haihong Liu
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Xin Ni
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Jie Zhang
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
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Antia SD, Lederberg AR, Easterbrooks S, Schick B, Branum-Martin L, Connor CM, Webb MY. Language and Reading Progress of Young Deaf and Hard-of-Hearing Children. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2020; 25:334-350. [PMID: 32052022 DOI: 10.1093/deafed/enz050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 11/21/2019] [Accepted: 12/05/2019] [Indexed: 06/10/2023]
Abstract
We examined the language and reading progress of 336 young DHH children in kindergarten, first and second grades. Trained assessors tested children's language, reading, and spoken and fingerspelled phonological awareness in the fall and spring of the school year. Children were divided into groups based on their auditory access and classroom communication: a spoken-only group (n = 101), a sign-only group (n = 131), and a bimodal group (n = 104). Overall, children showed delays in language and reading compared to norms established for hearing children. For language, vocabulary standard scores were higher than for English syntax. Although delayed in language, children made expected gains based on hearing norms from kindergarten to second grade. Reading scores declined from kindergarten to second grade. Spoken-only and bimodal children had similar word reading and reading comprehension abilities and higher scores than sign-only children. Spoken-only children had better spoken phonological awareness and nonword reading skills than the other two groups. The sign-only and bimodal groups made similar and significant gains in ASL syntax and fingerspelling phonological awareness.
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32
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Kumar V, Mehta R. Adaptation and validation of receptive expressive emergent Language Test-3: Evidence from Hindi speaking children with cochlear implant. Int J Pediatr Otorhinolaryngol 2020; 132:109891. [PMID: 32006860 DOI: 10.1016/j.ijporl.2020.109891] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 01/15/2020] [Accepted: 01/15/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Selection of an effective tool for assessment of language learning outcomes in post cochlear implantation is always an important but challenging task. Receptive expressive emergent language test-3rd Eds. (REELT-3) is one of the comprehensive language assessment tools used in India. In case of administration of REELT-3, which is standardized in English speaking typically developing western population, to another language speaking population with post-cochlear implant condition, the test outcome may get compromised owing to linguistics and population variability. The objective of the study is to test and validate REELT-3 in Hindi speaking children with cochlear implantation. METHODS Ninety six typically developing children (22.3 ± 6.9 months, 48 boys and 48 girls) and 96 children with cochlear implantation (25.8 ± 9.2 months, 57 boys and 39 girls) participated in this study. As per the eligibility criteria of REELT-3, infants and toddlers with cochlear implant of age below 36 months participated in this study. Criterion, content and construct validity were tested using correlation based statistical analysis. RESULTS High content validity was established by obtaining very low correlation coefficient r = 0.16 across two distinct population of typically developing children and children with cochlear implantation. Similarly, correlation coefficient of r = 0.84 revealed high criterion validity across REELT-3 in English and Hindi speaking conditions. Finally, correlation coefficient of r = 0.87was obtained between language raw score and chronological age to establish construct validity. Chronbach alpha coefficient (Chronbach α = 0.85) and interclass correlation coefficient 0.87was observed for REELT-3 which suggests good internal consistency and test-retest reliability, respectively. Receiver Operating Characteristics curve analysis of the REELT-3 suggested that area under curve 0.95 (95% CI = 0.89-0.99, p < 0.001) is excellent. The cut-off Language Ability Score (LAS) was determined as 74.5 with the sensitivity of 87.9% and specificity of 84.1% infer high sensitivity and specificity. CONCLUSIONS These results validate that REELT-3 can be used in assessment of language outcome in Hindi speaking children with post-cochlear implantation. Clinical assessment of receptive and expressive language will be beneficial in effective evaluation as well as in therapeutic planning.
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Affiliation(s)
- Vijay Kumar
- Department of Audiology & Speech-Language Pathology, Amity University, Gurgaon, Haryana, India.
| | - Rachna Mehta
- Amity Institute of Neuropsychology and Neurosciences, Amity University, Noida, Uttar Pradesh, India.
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Contemporary Speech and Oral Language Care for Deaf and Hard-of-Hearing Children Using Hearing Devices. J Clin Med 2020; 9:jcm9020378. [PMID: 32019213 PMCID: PMC7073554 DOI: 10.3390/jcm9020378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 11/16/2022] Open
Abstract
Contemporary speech and language interventions are not limited to disabilities but embrace the pragmatics of communication behaviors from the perspective of functional social participation. Accordingly, current speech and language therapies for deaf and hard-of-hearing children include a broad spectrum of approaches and techniques. This paper explores contemporary approaches and techniques for speech and oral language interventions for deaf and hard-of-hearing children using hearing devices, evidence of efficacy and how they are implemented in diverse clinical practices.
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Dale BA, Neild R. The assessment needs of families with children who are deaf and hard of hearing referred for an autism spectrum disorder evaluation. PSYCHOLOGY IN THE SCHOOLS 2019. [DOI: 10.1002/pits.22328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Brittany A. Dale
- Department of Special EducationBall State UniversityMuncie Indiana
| | - Raschelle Neild
- Department of Special EducationBall State UniversityMuncie Indiana
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Huber M, Havas C. Restricted Speech Recognition in Noise and Quality of Life of Hearing-Impaired Children and Adolescents With Cochlear Implants - Need for Studies Addressing This Topic With Valid Pediatric Quality of Life Instruments. Front Psychol 2019; 10:2085. [PMID: 31572268 PMCID: PMC6751251 DOI: 10.3389/fpsyg.2019.02085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 08/27/2019] [Indexed: 11/27/2022] Open
Abstract
Cochlear implants (CI) support the development of oral language in hearing-impaired children. However, even with CI, speech recognition in noise (SRiN) is limited. This raised the question, whether these restrictions are related to the quality of life (QoL) of children and adolescents with CI and how SRiN and QoL are related to each other. As a result of a systematic literature research only three studies were found, indicating positive moderating effects between SRiN and QoL of young CI users. Thirty studies addressed the quality of life of children and adolescents with CI. Following the criteria of the World Health Organization (WHO) for pediatric health related quality of life HRQoL (1994) only a minority used validated child centered and age appropriate QoL instruments. Moreover, despite the consensus that usually children and adolescents are the most prominent informants of their own QoL (parent-reports complement the information of the children) only a minority of investigators used self-reports. Restricted SRiN may be a burden for the QoL of children and adolescents with CI. Up to now the CI community does not seem to have focused on a possible impairment of QoL in young CI users. Further studies addressing this topic are urgently needed, which is also relevant for parents, clinicians, therapists, teachers, and policy makers. Additionally investigators should use valid pediatric QoL instruments. Most of the young CI users are able to inform about their quality of life themselves.
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Affiliation(s)
- Maria Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Clara Havas
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
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Auditory and language outcomes of unilateral cochlear implantation in shunt treated hydrocephalus: A case study. Int J Pediatr Otorhinolaryngol 2019; 124:94-98. [PMID: 31174025 DOI: 10.1016/j.ijporl.2019.05.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/24/2019] [Accepted: 05/25/2019] [Indexed: 11/21/2022]
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Toe D, Paatsch L, Szarkowski A. Assessing Pragmatic Skills Using Checklists with Children who are Deaf and Hard of Hearing: A Systematic Review. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2019; 24:189-200. [PMID: 30929005 DOI: 10.1093/deafed/enz004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/28/2019] [Indexed: 06/09/2023]
Abstract
This paper investigates the use of checklists to assess pragmatics in children and adolescents who are deaf and hard of hearing. A systematic literature review was undertaken to identify all of the published research articles between 1979 and 2018 on the topic of the assessment of pragmatics for this population of children and adolescents. The 67 papers identified in this review were analyzed and all papers that utilized a checklist to assess pragmatic skills were identified. Across the 18 different published papers on the use of pragmatic skills among children who are deaf and hard of hearing, nine checklists were identified. These nine checklists were then compared and contrasted on six key features including identification of a theoretical framework or model; the type of pragmatic skills measured; the age range of the child assessed; the information/outputs generated; the primary informant for the assessment; and reliability, validity, and normative data. The resulting analysis provides a comprehensive guide to aid clinicians, educators, and researchers in selecting an appropriate checklist to assess pragmatic skills for children and adolescents who are deaf and hard of hearing.
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Affiliation(s)
| | | | - Amy Szarkowski
- Children's Center for Communication/Beverly School for the Deaf, Department of Psychiatry, Harvard Medical School
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Hatano M, Kelly JB, Zhang H. Area-dependent change of response in the rat's inferior colliculus to intracochlear electrical stimulation following neonatal cochlear damage. Sci Rep 2019; 9:5643. [PMID: 30948747 PMCID: PMC6449351 DOI: 10.1038/s41598-019-41955-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 03/19/2019] [Indexed: 12/04/2022] Open
Abstract
To understand brain changes caused by auditory sensory deprivation, we recorded local-field potentials in the inferior colliculus of young adult rats with neonatal cochlear damage produced by systemic injections of amikacin. The responses were elicited by electrical stimulation of the entire cochlea and recorded at various locations along a dorsolateral-ventromedial axis of the inferior colliculus. We found that hair cells were completely destroyed and spiral ganglion neurons were severely damaged in the basal cochleae of amikacin-treated animals. Hair cells as well as spiral ganglion neurons were damaged also in the middle and apical areas of the cochlea, with the damage being greater in the middle than the apical area. Amplitudes of local-field potentials were reduced in the ventromedial inferior colliculus, but enhanced in the dorsolateral inferior colliculus. Latencies of responses were increased over the entire structure. The enhancement of responses in the dorsolateral inferior colliculus was in contrast with the damage of hair cells and spiral ganglion cells in the apical part of the cochlea. This contrast along with the overall increase of latencies suggests that early cochlear damage can alter neural mechanisms within the inferior colliculus and/or the inputs to this midbrain structure.
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Affiliation(s)
- Miyako Hatano
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University, Kanazawa, 920-8640, Ishikawa, Japan.
| | - Jack B Kelly
- Department of Neuroscience, Carleton University, Ottawa, Ontario, K1S 5B6, Canada
| | - Huiming Zhang
- Department of Biological Sciences, University of Windsor, Windsor, Ontario, N9B 3P4, Canada
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Abstract
Screening infants for hearing loss at birth is a standard in most states in the United States, but follow-up continues to warrant improvement. Understanding the definition of hearing loss, its etiology, appropriate intervention options, and knowledge of methods to optimize an infant's outcomes through the medical home can help to maximize speech and language skills.
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Affiliation(s)
- Jane E Stewart
- Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical University, Boston Children's Hospital, Rose 3, 330 Brookline Avenue, Boston, MA 02215, USA.
| | - Jennifer E Bentley
- Department of Neonatology, Beth Israel Deaconess Medical Center, Rose 3, 330 Brookline Avenue, Boston, MA 02215, USA
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