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De Raeve L, Cumpăt MC, van Loo A, Costa IM, Matos MA, Dias JC, Mârțu C, Cavaleriu B, Gherguț A, Maftei A, Tudorean OC, Butnaru C, Șerban R, Meriacre T, Rădulescu L. Quality Standard for Rehabilitation of Young Deaf Children Receiving Cochlear Implants. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1354. [PMID: 37512167 PMCID: PMC10386159 DOI: 10.3390/medicina59071354] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/10/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
Background and objectives: More and more children with severe-to-profound hearing loss are receiving cochlear implants (CIs) at an early age to improve their hearing and listening abilities, speech recognition, speech intelligibility, and other aspects of spoken language development. Despite this, the rehabilitation outcomes can be very heterogeneous in this population, not only because of issues related to surgery and fitting or the specific characteristics of the child with his/her additional disabilities but also because of huge differences in the quality of the support and rehabilitation offered by the therapist and the family. These quality standards for the rehabilitation of young deaf children receiving CIs are developed within the European KA202 Erasmus+ project "VOICE"-vocational education and training for speech and language therapists and parents for the rehabilitation of children with CIs, Ref. No.: 2020-1-RO01-KA202-080059. Material and methods: To develop these quality standards, we used the input from the face-to-face interviews of 11 local rehabilitation experts in CIs from the four partner countries of the project and the outcomes of the bibliographic analysis of 848 publications retrieved from six databases: Pub Med, Psych Info, CINAHL, Scopus, Eric, and Cochrane. Based on all this information, we created a first set of 32 quality standards over four domains: general, fitting, rehabilitation, and for professionals. Further on, the Delphi method was used by 18 international rehabilitation experts to discuss and agree on these standards. Results: The results from the literature analysis and the interviews show us that more than 90% of the consulted international experts agreed on 29 quality standards. They focus on different aspects of rehabilitation: the multidisciplinary team, their expertise and knowledge, important rehabilitation topics to focus on, and programming issues related to rehabilitation. Conclusions: These quality standards aim to optimize the activity of speech rehabilitation specialists so that they reach the optimal level of expertise. Also presented is the necessary equipment for the IC team to carry out the rehabilitation sessions in good conditions. This set of quality standards can be useful to ensure the appropriate postoperative care of these children. As a result, the rehabilitation process will be more relaxed, and therapists will have the opportunity to focus more on the specific needs of each child, with the provision of quality services, which will result in better results. This theme is particularly complex and dependent on multifactorial aspects of medicine, education, speech therapy, social work, and psychology that are very intricate and interdependent.
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Affiliation(s)
- Leo De Raeve
- Independent Information Center on CI's (ONICI), 3520 Zonhoven, Belgium
| | - Marinela-Carmen Cumpăt
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
- Department of Medical Specialties, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
| | - Aimée van Loo
- Prevention Center Zuyd, Zuyd University of Applied Science, Nieuw Eyckholt 300, 6419 DJ Heerlen, The Netherlands
| | - Isabel Monteiro Costa
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal
- Center for Research in Health Technologies and Services (CINTESIS@RISE), 4200-450 Porto, Portugal
| | - Maria Assunção Matos
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal
- Center for Research in Health Technologies and Services (CINTESIS@RISE), 4200-450 Porto, Portugal
| | - João Canossa Dias
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal
- Center for Research in Health Technologies and Services (CINTESIS@RISE), 4200-450 Porto, Portugal
| | - Cristian Mârțu
- Clinical Rehabilitation Hospital, 700661 Iasi, Romania
- Department of Medical Specialties, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
| | | | - Alois Gherguț
- Faculty of Psychology and Education Sciences, Department of Education Sciences, "Alexandru Ioan Cuza" University of Iași, 11 Carol I Boulevard, 700506 Iasi, Romania
| | - Alexandra Maftei
- Faculty of Psychology and Education Sciences, Department of Education Sciences, "Alexandru Ioan Cuza" University of Iași, 11 Carol I Boulevard, 700506 Iasi, Romania
| | - Ovidiu-Cristian Tudorean
- Faculty of Psychology and Education Sciences, Department of Education Sciences, "Alexandru Ioan Cuza" University of Iași, 11 Carol I Boulevard, 700506 Iasi, Romania
| | - Corina Butnaru
- Department of Medical Specialties, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Society of Otology and Cohlear Implant (SOIC), Str. Pantelimon Halipa nr 14, 700661 Iasi, Romania
| | - Roxana Șerban
- Department of Medical Specialties, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Society of Otology and Cohlear Implant (SOIC), Str. Pantelimon Halipa nr 14, 700661 Iasi, Romania
| | - Tatiana Meriacre
- Department of Medical Specialties, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Society of Otology and Cohlear Implant (SOIC), Str. Pantelimon Halipa nr 14, 700661 Iasi, Romania
| | - Luminița Rădulescu
- Department of Medical Specialties, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania
- Society of Otology and Cohlear Implant (SOIC), Str. Pantelimon Halipa nr 14, 700661 Iasi, Romania
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Vaideeswaran SR, Prathiba DG. A Comprehensive Outcome Framework of a Cochlear Implant Program at a University Hospital in Chennai: A Preliminary Report. Indian J Otolaryngol Head Neck Surg 2022; 74:6462-6467. [PMID: 36742610 PMCID: PMC9895441 DOI: 10.1007/s12070-021-02557-1] [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: 02/05/2021] [Accepted: 04/12/2021] [Indexed: 02/07/2023] Open
Abstract
The primary goal of the study was to assess the progress achieved across different implant age groups (0-2 years, 2.1-4 years and 4.1-6 years) using a comprehensive test battery approach targeting areas such as Audition, Speech Perception, Speech Intelligibility and Speech-Language.This cross-sectional study evaluated the outcomes of 40 children who underwent cochlear implantation at Sri Ramachandra Medical Centre, Chennai. A battery of tests included aided audiogram, Categorical Auditory Performance, Meaningful Auditory Integration Scale; Picture speech identification test in Tamil; Speech Intelligibility Rating Scale and Communication Developmental Eclectic Approach to Language Learning (COMDEALL) were administered to evaluate their auditory, speech perception, speech intelligibility and speech and language skills, respectively. The results of the study suggested that children implanted between 0 and 2 years of age demonstrated better performance in all tasks including audition, speech perception and intelligibility as well as speech and language when compared to the other two older groups. Children implanted between 0 and 2 years reached target milestones early in life similar to their hearing peers. However, children between (2.1- 4 years) also performed well and results indicated that they could catch up with intensive training. The present study reestablished the findings that early implantation (0-2 years) facilitates optimal progress when compared to implantation at later ages within the age range of 0-6 years. It also facilitates parent counseling regarding the realistic expectations with reference to different ages of implantation.
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Affiliation(s)
| | - Dawson Gladys Prathiba
- Department of Speech, Language and Hearing Sciences, Faculty of Allied Health Sciences, Sri Ramachandra Institute of Higher Education and Research, Deemed To Be University, Porur, Chennai, 600116 India
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Köse B, Karaman-Demirel A, Çiprut A. Psychoacoustic abilities in pediatric cochlear implant recipients: The relation with short-term memory and working memory capacity. Int J Pediatr Otorhinolaryngol 2022; 162:111307. [PMID: 36116181 DOI: 10.1016/j.ijporl.2022.111307] [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: 05/20/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim was to investigate school-age children with cochlear implants (CIs) and their typically developing peers in terms of auditory short-term memory (ASTM), auditory working memory (AWM), visuospatial short-term memory (VSTM), visuospatial working memory (VWM), spectral resolution and monosyllabic word recognition in noise. METHODS Twenty-three prelingually deaf CI users and twenty-three typically developing (TD) peers aged 7-10 years participated. Twelve children with CI were earlier-implanted (i.e., age at implantation ≤24 months). Children with CIs were compared to typically developing peers and correlations between cognitive and psychoacoustic abilities were computed separately for the groups. Besides, regression analyses were conducted to develop models that could predict SMRT (spectral-temporally modulated ripple test) and speech recognition scores. RESULTS The AWM scores of the later-implanted group were significantly lower than both earlier-implanted and TD groups. ASTM scores of TD children were significantly higher than both earlier-implanted and later-implanted participants. There was no statistically significant difference between groups in terms of VSTM and VWM. AWM performance was positively correlated with ASTM, SMRT scores, and speech recognition under noisy conditions for pediatric CI recipients. The AWM was a statistically significant predictor of the SMRT score and the SMRT score was an indicator of speech recognition score under 0 dB SNR condition. CONCLUSION Most of children using CI are at risk for clinically remarkable deficits across cognitive abilities such as AWM and ASTM. While evaluating cognitive and psychoacoustic abilities in the clinic routine, it should be kept in mind that they can be influenced by each other.
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Affiliation(s)
- Büşra Köse
- Department of Audiology, School of Medicine, Marmara University, Istanbul, Turkey; Koç University Research Center for Translational Medicine (KUTTAM), Istanbul, Turkey.
| | - Ayşenur Karaman-Demirel
- Department of Audiology, School of Medicine, Marmara University, Istanbul, Turkey; Vocational School of Health Services, Okan University, Istanbul, Turkey
| | - Ayça Çiprut
- Department of Audiology, School of Medicine, Marmara University, Istanbul, Turkey
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Sharma S, Solanki B, Solanki Y, Kaurani Y. Cochlear Implants: Evaluation of Effects of Various Parameters on Outcomes in Pediatric Patients at a Tertiary Care Centre for Unilateral Ear Implantation. Indian J Otolaryngol Head Neck Surg 2022; 74:360-367. [PMID: 36032881 PMCID: PMC9411418 DOI: 10.1007/s12070-020-02129-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 08/31/2020] [Indexed: 10/23/2022] Open
Abstract
To determine whether variables such as Age, Gender, Demographic background of the patient and Pre-operative usage of hearing aids affect the outcomes of pediatric cochlear implant surgery when modified; in terms of speech and hearing gain. A hospital based retrospective-prospective type of cohort study was conducted over a period of 5 years at a Tertiary care Teaching hospital and referral centre covering a population of about 68.9 million. Candidates selected were 1-5 years of age with bilateral congenital severe-profound sensori-neural hearing loss. 50 patients were selected and were operated using VERIA technique of Cochlear Implant Surgery. Intraoperative testing of electrode functioning was done in all patients using NRT technique. The switching on of implant was done after 1 month, following which patients underwent 100 sessions of auditory verbal therapy and training. Outcomes were evaluated in terms of hearing and speech gain by using Revised CAP scores, ITMAIS scores and PEACH scores in the loco-regional language. Those implanted at a younger age and with at least 3 months of hearing aid usage pre-operatively had better outcomes measures. There was no effect on outcomes when the gender and demographic origin of the patient were compared. Candidates implanted before 3 years age give better results and they should be encouraged to use hearing aid regularly and continuously before the surgery and should be advised trial and fitting as soon as CI planning begins. Also, gender and demographic background should not be considered when planning CI as these have no significant effect on outcomes.
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Affiliation(s)
- Shivam Sharma
- Department of Otorhinolaryngology and Head Neck Surgery, Dr. S. N. Medical College and M.D.M.Hospital, Jodhpur, Rajasthan 342003 India
- Jaipur, India
| | - Bharti Solanki
- Department of Otorhinolaryngology and Head Neck Surgery, Dr. S. N. Medical College and M.D.M.Hospital, Jodhpur, Rajasthan 342003 India
| | - Yogesh Solanki
- Department of Otorhinolaryngology and Head Neck Surgery, Dr. S. N. Medical College and M.D.M.Hospital, Jodhpur, Rajasthan 342003 India
| | - Yogesh Kaurani
- Department of Otorhinolaryngology and Head Neck Surgery, Dr. S. N. Medical College and M.D.M.Hospital, Jodhpur, Rajasthan 342003 India
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Lu HP, Lin CS, Wu CM, Peng SC, Feng IJ, Lin YS. The effect of lexical tone experience on English intonation perception in Mandarin-speaking cochlear-implanted children. Medicine (Baltimore) 2022; 101:e29567. [PMID: 35839064 PMCID: PMC11132337 DOI: 10.1097/md.0000000000029567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 04/26/2022] [Indexed: 11/25/2022] Open
Abstract
To examine the effect of lexical tone experience on English intonation perception in Mandarin-speaking cochlear-implanted children during second language acquisition in Taiwan. A retrospective cohort study. A tertiary referred center. Fourteen children with cochlear implant (CI) in the experimental group, and 9 normal hearing children in the control group were enrolled in this study. Cochlear implantation and hearing rehabilitation. Two speech recognition accuracies were examined: (1) Lexical tone recognition (4-alternative forced choice, AFC), (2) English Sentence Intonation (2AFC). The overall accuracies for tone perception are 61.13% (standard deviation, SD = 10.84%) for CI group and 93.82% (SD = 1.80%) for normal hearing group. Tone 4 and Tone 1 were more easily to be recognized than tone 2 and tone 3 in the pediatric CI recipients (cCI) group. In English intonation perception, the overall accuracies are 61.82% (SD = 16.85%) for CI group, and 97.59% (SD = 4.73%) for normal hearing group. Significant high correlation (R = .919, P ≦ .000) between lexical tone perception and English intonation perception is noted. There is no significant difference for English intonation perception accuracies between Mandarin-speaking cCI (61.82%) and English-speaking cCI (70.13%, P = .11). Mandarin-speaking cochlear-implanted children showed significant deficits in perception of lexical tone and English intonation relative to normal hearing children. There was no tonal language benefit in Mandarin-speaking cochlear-implanted children's English intonation perception, compared to the English-speaking cochlear-implanted peers. For cochlear-implanted children, better lexical tone perception comes with better English intonation perception. Enhancing Mandarin prosodic perception for cochlear-implanted children may benefit their command of intonation in English.
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Affiliation(s)
- Hui-Ping Lu
- Center of Speech and Hearing, Department of Otolaryngology, Chi Mei Medical Center, Tainan, Taiwan
| | - Chih-Shin Lin
- Center of Speech and Hearing, Department of Otolaryngology, Chi Mei Medical Center, Tainan, Taiwan
- Department of Speech and Language Therapy, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Che-Ming Wu
- Department of Otorhinolaryngology, New Taipei municipal TuCheng Hospital (built and operated by Chang Gung Medical Foundation), TuCheng, New Taipei City, Taiwan
- Department of Otorhinolaryngology, Chang Gung Memorial Hospital, Linkou, School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shu-Chen Peng
- Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD
| | - I. Jung Feng
- Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Yung-Song Lin
- Center of Speech and Hearing, Department of Otolaryngology, Chi Mei Medical Center, Tainan, Taiwan
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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AYDOĞAN M, ÜÇÜNCÜ MZ. Koklear İmplant Kullanan Çocukların İmplant Cihazını Günlük Kullanım Sürelerine Göre Konuşmayı Anlama Becerilerinin Değerlendirilmesi. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.38079/igusabder.989501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Koyama H, Kashio A, Fujimoto C, Uranaka T, Matsumoto Y, Kamogashira T, Kinoshita M, Iwasaki S, Yamasoba T. Alteration of Vestibular Function in Pediatric Cochlear Implant Recipients. Front Neurol 2021; 12:661302. [PMID: 34122305 PMCID: PMC8193854 DOI: 10.3389/fneur.2021.661302] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Vestibular dysfunction is a complication of cochlear implantation (CI). Reports on the evaluation of vestibular function before and after CI are limited, especially in children. We investigated the effect of CI on vestibular function in pediatric patients. Patients and Methods: We routinely evaluated vestibular function before but not immediately after CI. Therefore, patients who underwent sequential bilateral CI were enrolled in this study. Seventy-three children who underwent sequential CI from 2003 to 2020 at our hospital were included. Since the vestibular function of the first implanted ear was evaluated before the second surgery for the contralateral ear, post-CI evaluation timing differed among the cases. The evaluation included a caloric test, a cervical vestibular-evoked myogenic potential (cVEMP) test, and a damped rotation test. The objective variables included the results of these tests, and the explanatory variables included the age at surgery, cause of hearing loss, electrode type, and surgical approach used. The associations of these tests were analyzed. Results: cVEMP was the most affected after CI (36.1%), followed by the caloric test (23.6%), and damped rotation test (7.8%). Cochleostomy was significantly more harmful than a round window (RW) approach or an extended RW approach based on the results of the caloric test (p = 0.035) and damped rotation test (p = 0.029). Perimodiolar electrodes affected the caloric test results greater than straight electrodes (p = 0.041). There were no significant associations among these tests' results. Conclusions: Minimally invasive surgery in children using a round window approach or an extended round window approach with straight electrodes is desirable to preserve vestibular function after CI.
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Affiliation(s)
- Hajime Koyama
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akinori Kashio
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chisato Fujimoto
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tsukasa Uranaka
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yu Matsumoto
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Teru Kamogashira
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Makoto Kinoshita
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinichi Iwasaki
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medical Sciences and Medical School, Nagoya City University, Nagoya, Japan
| | - Tatsuya Yamasoba
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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De Raeve L, Kerkhofs K, de Smit M, Zegg D. Translation and validation of the revised version of the LittlEARS® early speech production questionnaire (LEESPQ®), in Dutch-speaking children with normal hearing. Cochlear Implants Int 2021; 22:216-222. [PMID: 33612085 DOI: 10.1080/14670100.2021.1884415] [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: 10/22/2022]
Abstract
INTRODUCTION With the introduction of newborn hearing screening, children with different degrees of hearing loss can receive hearing aids and cochlear implants in the early months after birth, which is also the case in the Netherlands and in Flanders, the Dutch speaking part of Belgium. MATERIALS AND METHODS This has intensified the need for a validated questionnaire in the Dutch language to assess the speech development of children under the age of two. The LittlEARS Early Speech Production Questionnaire® (LEESPQ®), which was originally developed and validated in German language, was translated and validated into the Dutch language. Questionnaires of 355 normal hearing children were analysed. RESULTS Total score was highly correlated with age (r = .775) and a normative curve was created. Internal consistency was reached with a high value of α = 0.870, which indicates that the questionnaire almost exclusively assesses speech production ability. The Dutch version of the LEESPQ®, is reliable, consistent and independent of gender or lingual status. As such, the Dutch LEESPQ®, may be a useful tool for language monitoring for children from birth to 18 months of age. CONCLUSION The Dutch LittlEARS Early Speech Production Questionnaire®, was found to be a reliable and valid tool to assess and monitor the early speech and language production skills in children up to 18 months of age.
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Affiliation(s)
- Leo De Raeve
- ONICI, Independent Information and Research Centre on Cochlear Implants, Zonhoven, Belgium
| | | | | | - Diana Zegg
- MED-EL Worldwide Headquarters, Innsbruck, Austria
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The Effect of Age at Cochlear Implantation on Speech and Auditory Performances in Prelingually Deaf Children. Indian J Otolaryngol Head Neck Surg 2020; 74:52-61. [PMID: 36032837 PMCID: PMC9411477 DOI: 10.1007/s12070-020-01821-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 02/12/2020] [Indexed: 11/26/2022] Open
Abstract
To understand the effect of age at implantation on speech and auditory performances of 74 prelingually deaf Indian children after using cochlear implants for 3, 6 and 12 months. We also evaluate the causes of late implantation in this population. Seventy four children who underwent cochlear implantation from December 2013 to December 2015 in the Department of Otorhinolaryngology and Head Neck Cancer in SMS Medical College, Jaipur were participated in this study. To compare the efficacy of cochlear implant, candidates are classified into 2 groups according to the age at the time of implantation: 1-4 years and 4.1-7 years. The sample size is 37 in both age groups. Their auditory performance and speech intelligibility were rated using the Revised Categories of Auditory Perception scales, Speech Intelligibility Rating scales and Meaningful Auditory Integration Scale. The evaluations were made before implantation and 3, 6 and 12 months after implantation. The scores when compared in both the groups revealed that the results were comparable and significant after 12 months of follow up while the scores were not significant after 3 and 6 months. The results were statistically significant when baseline is compared with different postoperative stages. The children implanted before the age of 4 years had significantly better auditory and linguistic performances. At least 12 months of audio-verbal rehabilitation and speech and language therapy are required to compare the effects of cochlear implant in any set of children. Our study shows that hearing impaired children who receive cochlear implantation below 4 years of age acquires better auditory ability for developing language skills.
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Arya R, Nandurkar A, Shah M, Verma N. Speech Perception Skills of Hindi Speaking Children with Pre-lingual Hearing Loss Using Hearing Aids and Cochlear Implants. Indian J Otolaryngol Head Neck Surg 2019; 71:1241-1247. [PMID: 31750159 PMCID: PMC6841839 DOI: 10.1007/s12070-018-1291-x] [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: 11/28/2017] [Accepted: 02/26/2018] [Indexed: 11/27/2022] Open
Abstract
Very few published studies have reported auditory speech perception in Hindi children with pre-lingual hearing loss. The study is aimed at comparing the speech perception skills of Hindi speaking children with pre-lingual severe to profound hearing loss using hearing aids and cochlear implants. Forty-three 6 to 8-year old children were included as participants, of which 22 were bilateral behind-the-ear hearing aid (HA) users and 21 were unilateral cochlear implant (CI) users. Speech perception was assessed through a forced-choice, picture-pointing task using recorded stimuli presented at 70 dB HL in the sound field. The skills assessed include: (a) pattern perception, (b) bisyllabic word identification, (c) monosyllabic word identification, (d) sentence identification and (e) minimal pair identification. Children using CI consistently performed significantly better than those with HA on all tasks. For the skills assessed, best performance was seen in pattern perception and poorest performance was seen in monosyllabic word identification. One participant from the CI group obtained ceiling scores for pattern perception and bisyllabic word identification. There was no statistically significant difference in the performance of 6 to 7 and 7 to 8-year-old children for any of the tasks. Children fitted with CI have better access to the cues important for perception of speech and hence perform consistently better than those using hearing aids. Recorded speech perception test can be used with children using cochlear implants and hearing aids.
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Affiliation(s)
- Richa Arya
- ENT Department, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab 151203 India
| | - Aparna Nandurkar
- Ali Yavar Jung National Institute of Speech and Hearing Disabilities, Mumbai, India
| | - Meera Shah
- Ali Yavar Jung National Institute of Speech and Hearing Disabilities, Mumbai, India
| | - Neha Verma
- Ali Yavar Jung National Institute of Speech and Hearing Disabilities, Mumbai, India
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Goodwin C, Lillo-Martin D. Morphological Accuracy in the Speech of Bimodal Bilingual Children with CIs. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2019; 24:435-447. [PMID: 31063195 PMCID: PMC6786513 DOI: 10.1093/deafed/enz019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/19/2019] [Accepted: 04/17/2019] [Indexed: 05/29/2023]
Abstract
Sign language use in the (re)habilitation of children with cochlear implants (CIs) remains a controversial issue. Concerns that signing impedes spoken language development are based on research comparing children exposed to spoken and signed language (bilinguals) to children exposed only to speech (monolinguals), although abundant research demonstrates that bilinguals and monolinguals differ in language development. We control for bilingualism effects by comparing bimodal bilingual (signing-speaking) children with CIs (BB-CI) to those with typical hearing (BB-TH). Each child had at least one Deaf parent and was exposed to ASL from birth. The BB-THs were exposed to English from birth by hearing family members, while the BB-CIs began English exposure after cochlear implantation around 22-months-of-age. Elicited speech samples were analyzed for accuracy of English grammatical morpheme production. Although there was a trend toward lower overall accuracy in the BB-CIs, this seemed driven by increased omission of the plural -s, suggesting an exaggerated role of perceptual salience in this group. Errors of commission were rare in both groups. Because both groups were bimodal bilinguals, trends toward group differences were likely caused by delayed exposure to spoken language or hearing through a CI, rather than sign language exposure.
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Long-term follow-up of auditory performance and speech perception and effects of age on cochlear implantation in children with pre-lingual deafness. Chin Med J (Engl) 2019; 132:1925-1934. [PMID: 31365431 PMCID: PMC6708680 DOI: 10.1097/cm9.0000000000000370] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: The development of auditory and speech perception ability of children with hearing loss is affected by many factors after they undergo cochlear implantation (CI). Age at CI (CI age) appears to play an important role among these factors. This study aimed to evaluate the development of auditory and speech perception ability and explore the impact of CI age on children with pre-lingual deafness present before 3 years of age. Methods: Two hundred and seventy-eight children with pre-lingual deafness (176 boys and 102 girls) were included in this study, and the CI age ranged from 6 to 36 months (mean age, 19 months). Categorical auditory performance (CAP) was assessed to evaluate auditory ability, and the speech intelligibility rating was used to evaluate speech intelligibility. The evaluations were performed before CI and 1, 3, 6, 12, 18, 24, 36, 48, and 60 months after CI. Results: The auditory ability of the pre-lingually hearing-impaired children showed the fastest development within 6 months after CI (k = 0.524, t = 30.992, P < 0.05); then, the progress started to decelerate (k = 0.14, t = 3.704, P < 0.05) and entered a plateau at the 24th month (k = 0.03, t = 1.908, P < 0.05). Speech intelligibility showed the fastest improvement between the 12th and 24th months after CI (k = 0.138, t = 5.365, P < 0.05); then, the progress started to decelerate (k = 0.026, t = 1.465, P < 0.05) and entered a plateau at the 48th month (k = 0.012, t = 1.542, P < 0.05). The CI age had no statistical significant effect on the auditory and speech abilities starting at 2 years after CI (P > 0.05). The optimal cutoff age for CI was 15 months. Conclusions: Within 5 years after CI, the auditory and speech ability of young hearing-impaired children continuously improved, although speech development lagged behind that of hearing. An earlier CI age is recommended; the optimal cutoff age for CI is at 15 months.
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Deaf Children as ‘English Learners’: The Psycholinguistic Turn in Deaf Education. EDUCATION SCIENCES 2019. [DOI: 10.3390/educsci9020133] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this literature review is to present the arguments in support of conceptualizing deaf children as ‘English Learners’, to explore the educational implications of such conceptualizations, and to suggest directions for future inquiry. Three ways of interpreting the label ‘English Learner’ in relationship to deaf children are explored: (1) as applied to deaf children whose native language is American Sign Language; (2) as applied to deaf children whose parents speak a language other than English; and (3) as applied to deaf children who have limited access to the spoken English used by their parents. Recent research from the fields of linguistics and neuroscience on the effects of language deprivation is presented and conceptualized within a framework that we refer to as the psycholinguistic turn in deaf education. The implications for developing the literacy skills of signing deaf children are explored, particularly around the theoretical construct of a ‘bridge’ between sign language proficiency and print-based literacy. Finally, promising directions for future inquiry are presented.
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Categorization of everyday sounds by cochlear implanted children. Sci Rep 2019; 9:3532. [PMID: 30837546 PMCID: PMC6401047 DOI: 10.1038/s41598-019-39991-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 01/21/2019] [Indexed: 11/09/2022] Open
Abstract
Auditory categorization is an important process in the perception and understanding of everyday sounds. The use of cochlear implants (CIs) may affect auditory categorization and result in poor abilities. The current study was designed to compare how children with normal hearing (NH) and children with CIs categorize a set of everyday sounds. We tested 24 NH children and 24 children with CI on a free-sorting task of 18 everyday sounds corresponding to four a priori categories: nonlinguistic human vocalizations, environmental sounds, musical sounds, and animal vocalizations. Multiple correspondence analysis revealed considerable variation within both groups of child listeners, although the human vocalizations and musical sounds were similarly categorized. In contrast to NH children, children with CIs categorized some sounds according to their acoustic content rather than their associated semantic information. These results show that despite identification deficits, children with CIs are able to categorize environmental and vocal sounds in a similar way to NH children, and are able to use categorization as an adaptive process when dealing with everyday sounds.
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Speech development in young children with Mondini dysplasia who had undergone cochlear implantation. Int J Pediatr Otorhinolaryngol 2019; 116:118-124. [PMID: 30554681 DOI: 10.1016/j.ijporl.2018.10.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the development of speech skills in young children with Mondini dysplasia and age-matched deaf children with radiologically normal inner ears over a period of 5 years after cochlear implantation (CI). METHODS In total, 700 congenitally severely to profoundly deaf children (281 girls and 419 boys) participated in this study. All of the participants had undergone unilateral CI surgery before 36 months of age. The participants were categorized into two groups based on the absence or presence of Mondini dysplasia in the implanted ear, as assessed via high-resolution, thin-slice computerized tomography or magnetic resonance imaging: group A comprised 592 children with radiologically normal inner ears and group B comprised 108 children with Mondini dysplasia. The Meaningful Use of Speech Scale (MUSS) and Speech Intelligibility Rating (SIR) were used to evaluate the speech performance of all young children at various time points: pre-surgery and at 1, 3, 6, 12, 24, 36, 48, and 60 months after switch-on programming. RESULTS The mean scores of SIR and MUSS in children from both group A and group B showed significant improvements over time. No significant differences were found in the mean scores of SIR between the two groups at any time interval during the 5-year follow-up. The mean score of MUSS was significantly different between group A and group B at 12, 24, and 36 months after implantation, whereas no obvious differences were noted pre-surgery, and at 1, 3, 6, 48, and 60 months post-operation. CONCLUSIONS Young children with Mondini dysplasia develop their speech skills at a fast rate and achieve similar speech acquisition compared to age-matched children with radiologically normal inner ears 5 years post-operation. Therefore, CI is an effective intervention method for young children with Mondini dysplasia.
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Al-Sayed AA, AlSanosi A. Cochlear implants in children: A cross-sectional investigation on the influence of geographic location in Saudi Arabia. J Family Community Med 2017; 24:118-121. [PMID: 28566977 PMCID: PMC5426103 DOI: 10.4103/jfcm.jfcm_142_15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION: The role of the family in detecting a child's hearing difficulty and the age at which an implantation is done have been identified as strong predictors of the outcomes of pediatric cochlear implantation. In the absence of screening programs for hearing loss in Saudi neonates, the family's role is of paramount importance. The aim of this study was to investigate the influence of geographic location on the course of identification, examination, and cochlear implantation in children in Saudi Arabia. MATERIALS AND METHODS: Pediatric patients who had received either unilateral or bilateral cochlear implantation at King Abdulaziz University Hospital in Riyadh, Saudi Arabia, between January 1, 2012, and December 31, 2014, were surveyed. RESULTS: A total of 156 pediatric patients have had a cochlear implant between January 1, 2012, and December 31, 2014. The one-way analysis of variance test to compare the means of the independent sample groups in various geographic zones showed that with a hundred percent access to primary health care, the geographic location of the population had an influence on the detection of hearing loss but not on the cochlear implantation. CONCLUSION: This study found that the geographic location of the population has an influence on the time of detection of hearing loss in children but not on the time of cochlear implantation. Raising parental awareness of the importance of early detection of hearing loss is necessary. Further research is also required to define the role of factors such as the income and the educational level of parents on the early detection of neonatal hearing loss.
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Affiliation(s)
- Ahmed A Al-Sayed
- Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman AlSanosi
- Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia.,King Abdullah Ear Specialist Center (KAESC), Riyadh, Saudi Arabia
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Koşaner J, Deniz H, Uruk D, Deniz M, Kara E, Amann E. Assessment of early language development in Turkish children with a cochlear implant using the TEDIL test. Cochlear Implants Int 2017; 18:153-161. [PMID: 28293989 DOI: 10.1080/14670100.2017.1299392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To analyse language development of children with a cochlear implant (CI) in relation to length of CI use and age at implantation and to examine the suitability of the TEDIL as an assessment tool for measuring early language development in Turkish children. METHODS A total of 119 children implanted with a CI before 5 years of age were assessed acutely on sound field thresholds, speech recognition thresholds, open-set and closed-set monosyllabic word tests, the TEDIL, categories of auditory performance (CAP), and speech intelligibility rating (SIR). The outcome scores were analysed in relation to length of CI use (3, 4, and 5 years) and age at implantation (<24 months vs. >24 months). The TEDIL scores were compared to all other outcome measures. RESULTS Scores significantly increased with CI experience. CAP and SIR were significantly higher in the younger implanted group. No significant difference was observed between the younger and older implanted group on the closed-set and open-set monosyllabic tests and the TEDIL. The TEDIL scores significantly correlated with CAP, SIR, and the closed-set and open-set word scores. The mean TEDIL standard score was close to average. CONCLUSIONS Performance of CI users improves with increased CI experience. CI users implanted <24 months tend to have better auditory skills and clearer speech than CI users implanted >24 months. CI users implanted between 24 months and 60 months tend to develop language similarly to CI users implanted <24 months. The TEDIL is a suitable tool for assessing early receptive and expressive language development in Turkish children.
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Affiliation(s)
- Julie Koşaner
- a MEDers Turkey , Meşrutiyet Caddesi Hatay Sok No: 24/4 Kocatepe/Kızılay, 06640 Ankara , Turkey
| | - Hüseyin Deniz
- a MEDers Turkey , Meşrutiyet Caddesi Hatay Sok No: 24/4 Kocatepe/Kızılay, 06640 Ankara , Turkey
| | - Deniz Uruk
- a MEDers Turkey , Meşrutiyet Caddesi Hatay Sok No: 24/4 Kocatepe/Kızılay, 06640 Ankara , Turkey
| | - Murat Deniz
- a MEDers Turkey , Meşrutiyet Caddesi Hatay Sok No: 24/4 Kocatepe/Kızılay, 06640 Ankara , Turkey
| | - Eyup Kara
- a MEDers Turkey , Meşrutiyet Caddesi Hatay Sok No: 24/4 Kocatepe/Kızılay, 06640 Ankara , Turkey
| | - Edda Amann
- b MED-EL Innsbruck , Fürstenweg 77a, 6020 Innsbruck , Austria
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Duchesne L, Millette I, Bhérer M, Gobeil S. Auditory performance and subjective benefits in adults with congenital or prelinguistic deafness who receive cochlear implants during adulthood. Cochlear Implants Int 2017; 18:143-152. [DOI: 10.1080/14670100.2017.1290925] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Louise Duchesne
- Département d'orthophonie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Isabelle Millette
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
| | - Maurice Bhérer
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
| | - Suzie Gobeil
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, Canada
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Silva LAF, Couto MIV, Magliaro FCL, Tsuji RK, Bento RF, de Carvalho ACM, Matas CG. Cortical maturation in children with cochlear implants: Correlation between electrophysiological and behavioral measurement. PLoS One 2017; 12:e0171177. [PMID: 28151961 PMCID: PMC5289550 DOI: 10.1371/journal.pone.0171177] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 01/17/2017] [Indexed: 11/18/2022] Open
Abstract
Central auditory pathway maturation in children depends on auditory sensory stimulation. The objective of the present study was to monitor the cortical maturation of children with cochlear implants using electrophysiological and auditory skills measurements. The study was longitudinal and consisted of 30 subjects, 15 (8 girls and 7 boys) of whom had a cochlear implant, with a mean age at activation time of 36.4 months (minimum, 17 months; maximum, 66 months), and 15 of whom were normal-hearing children who were matched based on gender and chronological age. The auditory and speech skills of the children with cochlear implants were evaluated using GASP, IT-MAIS and MUSS measures. Both groups underwent electrophysiological evaluation using long-latency auditory evoked potentials. Each child was evaluated at three and nine months after cochlear implant activation, with the same time interval adopted for the hearing children. The results showed improvements in auditory and speech skills as measured by IT-MAIS and MUSS. Similarly, the long-latency auditory evoked potential evaluation revealed a decrease in P1 component latency; however, the latency remained significantly longer than that of the hearing children, even after nine months of cochlear implant use. It was observed that a shorter P1 latency corresponded to more evident development of auditory skills. Regarding auditory behavior, it was observed that children who could master the auditory skill of discrimination showed better results in other evaluations, both behavioral and electrophysiological, than those who had mastered only the speech-detection skill. Therefore, cochlear implant auditory stimulation facilitated auditory pathway maturation, which decreased the latency of the P1 component and advanced the development of auditory and speech skills. The analysis of the long-latency auditory evoked potentials revealed that the P1 component was an important biomarker of auditory development during the rehabilitation process.
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Affiliation(s)
| | | | | | - Robinson Koji Tsuji
- Department of Otorhinolaryngology, Clinical Hospital, FMUSP, São Paulo (SP), Brazil
| | | | | | - Carla Gentile Matas
- Department of Physical, Speech and Occupational, FMUSP, São Paulo (SP), Brazil
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Knight K, Ducasse S, Coetzee A, van der Linde J, Louw A. The effect of age of cochlear implantation on vocal characteristics in children. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2016; 63:142. [PMID: 27380914 PMCID: PMC5843142 DOI: 10.4102/sajcd.v63i1.142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 04/18/2016] [Accepted: 04/04/2016] [Indexed: 11/29/2022] Open
Abstract
Background Early cochlear implantation aids auditory feedback and supports better communication and self-monitoring of the voice. The objective of this study was to determine whether the age of cochlear implantation has an impact on vocal development in children implanted before age 4. Method and procedures The study consisted of 19 participants in total. All implant recipients (experimental group) were 3–5 years post-implantation, including four prelingual (0–2 years) and five perilingual (2–4 years) implant recipients. The control group consisted of 10 children whose hearing was within normal limits between the ages 3–6 years and 10 months, which was compared to the experimental group. Established paediatric norms were used for additional comparison. A questionnaire was used to gather information from each of the participant’s caregivers to determine whether other personal and contextual factors had an impact on voice production. An acoustic analysis was conducted for each participant using the Multi-Dimensional Voice Program of the Computerized Speech Lab. Results When the experimental group and the control group were compared, similar results were yielded for fundamental frequency and short-term perturbation (jitter and shimmer). More variability was noted in long-term frequency and amplitude measures, with significantly higher differences, and therefore further outside the norms, in the prelingual group when compared to the perilingual and control groups. Conclusion In this study, age of implantation did not impact vocal characteristics. Further research should include larger sample sizes, with participants that are age and gender matched.
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Knight K, Ducasse S, Coetzee A, van der Linde J, Louw A. The effect of age of cochlear implantation on vocal characteristics in children. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2016. [DOI: 10.4102/sajcd.vxix.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Bruijnzeel H, Ziylan F, Stegeman I, Topsakal V, Grolman W. A Systematic Review to Define the Speech and Language Benefit of Early (<12 Months) Pediatric Cochlear Implantation. Audiol Neurootol 2016; 21:113-26. [DOI: 10.1159/000443363] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 12/14/2015] [Indexed: 11/19/2022] Open
Abstract
Objective: This review aimed to evaluate the additional benefit of pediatric cochlear implantation before 12 months of age considering improved speech and language development and auditory performance. Materials and Methods: We conducted a search in PubMed, EMBASE and CINAHL databases and included studies comparing groups with different ages at implantation and assessing speech perception and speech production, receptive language and/or auditory performance. We included studies with a high directness of evidence (DoE). Results: We retrieved 3,360 articles. Ten studies with a high DoE were included. Four articles with medium DoE were discussed in addition. Six studies compared infants implanted before 12 months with children implanted between 12 and 24 months. Follow-up ranged from 6 months to 9 years. Cochlear implantation before the age of 2 years is beneficial according to one speech perception score (phonetically balanced kindergarten combined with consonant-nucleus-consonant) but not on Glendonald auditory screening procedure scores. Implantation before 12 months resulted in better speech production (diagnostic evaluation of articulation and phonology and infant-toddler meaningful auditory integration scale), auditory performance (Categories of Auditory Performance-II score) and receptive language scores (2 out of 5; Preschool Language Scale combined with oral and written language skills and Peabody Picture Vocabulary Test). Conclusions: The current best evidence lacks level 1 evidence studies and consists mainly of cohort studies with a moderate to high risk of bias. Included studies showed consistent evidence that cochlear implantation should be performed early in life, but evidence is inconsistent on all speech and language outcome measures regarding the additional benefit of implantation before the age of 12 months. Long-term follow-up studies are necessary to provide insight on additional benefits of early pediatric cochlear implantation.
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Liu X, de Villiers J, Lee W, Ning C, Rolfhus E, Hutchings T, Jiang F, Zhang Y. New language outcome measures for Mandarin speaking children with hearing loss. J Otol 2016; 11:24-32. [PMID: 29937807 PMCID: PMC6002582 DOI: 10.1016/j.joto.2016.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 04/01/2016] [Accepted: 04/01/2016] [Indexed: 11/26/2022] Open
Abstract
Objective The paper discusses recent evidence on the assessment of language outcomes in children with hearing loss acquiring oral language. Methods Research emphasizes that language tests must be specific enough to capture subtle deficits in vocabulary and grammar learning at different developmental ages. The Diagnostic Receptive and Expressive Assessment of Mandarin (DREAM) was carefully designed to be a comprehensive standardized Mandarin assessment normed in Mainland China. Results This paper summarizes the evidence-based item design process and validity and reliability results of DREAM. A pilot study reported here shows that DREAM provided detailed information about hearing impaired children's language abilities and can be used to aid intervention planning to maximize progress. Conclusion DREAM represents an example of translational science, transferring methods from empirical studies of language acquisition in research environments into applied domains such as assessment and intervention. Research on outcomes in China will advance significantly with the availability of evidence-based comprehensive language tests that measure a sufficient age range of skills, are normed on Mandarin speaking children in mainland China, and are designed to capture features central to Mandarin language acquisition.
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Affiliation(s)
- Xueman Liu
- University of Texas at Dallas, Communication Sciences and Disorders, Bethel Hearing and Speaking Training Center, Research and Development, USA
| | - Jill de Villiers
- Smith College, Psychology and Philosophy, Bethel Hearing and Speaking Training Center, Research and Development, USA
| | - Wendy Lee
- University of Texas at Dallas, Communication Sciences and Disorders, Bethel Hearing and Speaking Training Center, Research and Development, USA
| | - Chunyan Ning
- Tianjin Normal University, Institute of Linguistics, Bethel Hearing and Speaking Training Center, Research and Development, China
| | - Eric Rolfhus
- Bethel Hearing and Speaking Training Center, Research and Development, USA
| | - Teresa Hutchings
- Bethel Hearing and Speaking Training Center, Research and Development, USA
| | - Fan Jiang
- Shanghai Children's Medical Center, Department of Developmental and Behavioral Pediatrics, China
| | - Yiwen Zhang
- Shanghai Children's Medical Center, Department of Developmental and Behavioral Pediatrics, China
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Li Y, Dong R, Zheng Y, Xu T, Zhong Y, Meng C, Guo Q, Wu W, Chen X. Speech performance in pediatric users of Nurotron ® Venus™ cochlear implants. Int J Pediatr Otorhinolaryngol 2015; 79:1017-23. [PMID: 25935509 DOI: 10.1016/j.ijporl.2015.04.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 04/09/2015] [Accepted: 04/12/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The primary purpose of this study was to investigate the longitudinal speech performance over 3 years in pediatric users of the Nurotron(®) cochlear implant system. The secondary purpose was to compare the speech performances of younger and older children with cochlear implants (CIs). METHODS The Mandarin Early Speech Perception (MESP), Meaningful Use of Speech Scale (MUSS), and Putonghua Chinese Communicative Development Inventory (PCDI) were used to evaluate speech performance of 22 Mandarin-speaking pediatric CI users throughout the first 36 months post-implantation. The subjects were grouped according to the age at implantation, i.e., younger CI group (<3 years) and older CI group (>3 years). RESULTS All the subjects demonstrated improvement in speech performance throughout the first 3 years of implant use with mean scores reaching the maximum performance at 36 months post-implantation. The median categories of MESP increased from 0.23 pre-implantation to 5.57 three years post-implantation. Likewise, the median percentage of MUSS was 5.57% to 73.75%; the median performance of PCDI was 55 to 400 for PCDI-comprehension and 32 to 384 for PCDI-production at the same interval. At nearly all test intervals, the older group performed better than the younger group except 24 months post-implantation, at which the MUSS score of the younger CI group was higher than that of the older CI group. CONCLUSION The children with Nurotron(®) Venus™ CI system showed considerable gains in speech and language development including tone performance which improved with hearing age. Earlier implantations haven't presented significantly positive performances until 24 months post-implantation in all the tests.
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Affiliation(s)
- Yuling Li
- Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Ruijuan Dong
- Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Yan Zheng
- Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Tianqiu Xu
- Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Yan Zhong
- Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Chao Meng
- Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Qianqian Guo
- Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Wenfang Wu
- Department of Biology Medical Engineering, Capital Medical University, Beijing 100069, China.
| | - Xueqing Chen
- Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China.
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Ramos D, Jorge JX, Teixeira A, Ribeiro C, Paiva A. Desenvolvimento da linguagem em crianças com implante coclear: terá o gênero alguma influência? REVISTA CEFAC 2015. [DOI: 10.1590/1982-021620155214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVO:avaliar a influencia do gênero no desenvolvimento da linguagem de crianças com surdez severa a profunda neurossensorial, após implante coclear.MÉTODOS:foram estudadas 30 crianças, 12 do gênero feminino e 18 do masculino, entre os 8 anos e 1 mês e os 10 anos com surdez severa a profunda neurossensorial bilateral congênita com implante coclear. Avaliaram-se as estruturas linguísticas semântica, morfossintaxe e fonologia. Utilizou-se o instrumento de avaliação: Grelha de Observação da Linguagem - nível escolar.RESULTADOS:a idade auditiva média foi de 72 meses no gênero feminino e 72.7 meses no masculino. As pontuações obtidas nos três níveis linguisticos foram estatisticamente semelhantes, quando comparados os gêneros. Nas provas de cada estrutura linguística também não se verificaram diferenças estatisticamente significantes.CONCLUSÕES:o gênero não influenciou o desenvolvimento da linguagem oral nas crianças utilizadoras de implante coclear, nas três estruturas linguísticas estudadas.
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Affiliation(s)
- Daniela Ramos
- Centro Hospitalar e Universitário de Coimbra, Portugal
| | | | | | | | - António Paiva
- Centro Hospitalar e Universitário de Coimbra, Portugal
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Brazilian adaptation of the Functioning after Pediatric Cochlear Implantation (FAPCI): comparison between normal hearing and cochlear implanted children. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2015. [DOI: 10.1016/j.jpedp.2015.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Vassoler TMF, Cordeiro ML. Brazilian adaptation of the Functioning after Pediatric Cochlear Implantation (FAPCI): comparison between normal hearing and cochlear implanted children. J Pediatr (Rio J) 2015; 91:160-7. [PMID: 25458875 DOI: 10.1016/j.jped.2014.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 06/05/2014] [Accepted: 06/11/2014] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Enabling development of the ability to communicate effectively is the principal objective of cochlear implantation (CI) in children. However, objective and effective metrics of communication for cochlear-implanted Brazilian children are lacking. The Functioning after Pediatric Cochlear Implantation (FAPCI), a parent/caregiver reporting instrument developed in the United States, is the first communicative performance scale for evaluation of real-world verbal communicative performance of 2-5-year-old children with cochlear implants. The primary aim was to cross-culturally adapt and validate the Brazilian-Portuguese version of the FAPCI. The secondary aim was to conduct a trial of the adapted Brazilian-Portuguese FAPCI (FAPCI-BP) in normal hearing (NH) and CI children. METHODS The American-English FAPCI was translated by a rigorous forward-backward process. The FAPCI-BP was then applied to the parents of children with NH (n=131) and CI (n=13), 2-9 years of age. Test-retest reliability was verified. RESULTS The FAPCI-BP was confirmed to have excellent internal consistency (Cronbach's alpha > 0.90). The CI group had lower FAPCI scores (58.38 ± 22.6) than the NH group (100.38 ± 15.2; p<0.001, Wilcoxon test). CONCLUSION The present results indicate that the FAPCI-BP is a reliable instrument. It can be used to evaluate verbal communicative performance in children with and without CI. The FAPCI is currently the only psychometrically-validated instrument that allows such measures in cochlear-implanted children.
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Affiliation(s)
- Trissia M F Vassoler
- Faculdades Pequeno Príncipe, Curitiba, PR, Brazil; Department of Otorhinolaryngology, Hospital Infantil Pequeno Príncipe, Curitiba, PR, Brazil
| | - Mara L Cordeiro
- Faculdades Pequeno Príncipe, Curitiba, PR, Brazil; Department of Otorhinolaryngology, Hospital Infantil Pequeno Príncipe, Curitiba, PR, Brazil; Neurosciences Group, Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, PR, Brazil; Department of Psychiatry and Biobehavioral Sciences of the David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, United States.
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De Raeve L, Wouters A. Accessibility to cochlear implants in Belgium: state of the art on selection, reimbursement, habilitation, and outcomes in children and adults. Cochlear Implants Int 2013; 14 Suppl 1:S18-25. [PMID: 23453148 PMCID: PMC3663287 DOI: 10.1179/1467010013z.00000000078] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Belgium, and especially the northern region called Flanders, has been a center of expertise in cochlear implants and early hearing screening for many years. Some of their surgeons and engineers were pioneers in the development of cochlear implants and in 1998 Flanders was the first region in Europe to implement a universal hearing screening program for all neonates. The Belgian National Institute for Health and Disability Insurance has reimbursed cochlear implants in children and adults since 1994 and bilateral implantation in children under the age of 12 years since February 2010. These deaf children, screened and implanted early, achieve higher auditory, speech and language outcomes and increasing numbers are going to regular schools using fewer interpreters. In 2010, 93% of severe-to-profound deaf preschool children in Flanders had received cochlear implants and 25% had bilateral implants. Although on average twice as many adults as children are implanted a year in Belgium, we have less research data available from this adult population. Also very little is published about the growth curves and minimal rehabilitation requirements (intensity, duration etc.) after implantation for both children and adults. So, there still remain many challenges for the future.
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Affiliation(s)
- Leo De Raeve
- Independent Information Center on Cochlear Implants (ONICI), Zonhoven, Belgium.
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A case study assessing the auditory and speech development of four children implanted with cochlear implants by the chronological age of 12 months. Case Rep Otolaryngol 2013; 2013:359218. [PMID: 23509653 PMCID: PMC3590554 DOI: 10.1155/2013/359218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 12/25/2012] [Indexed: 11/17/2022] Open
Abstract
Children with severe hearing loss most likely receive the greatest benefit from a cochlear implant (CI) when implanted at less than 2 years of age. Children with a hearing loss may also benefit greater from binaural sensory stimulation. Four children who received their first CI under 12 months of age were included in this study. Effects on auditory development were determined using the German LittlEARS Auditory Questionnaire, closed- and open-set monosyllabic word tests, aided free-field, the Mainzer and Göttinger speech discrimination tests, Monosyllabic-Trochee-Polysyllabic (MTP), and Listening Progress Profile (LiP). Speech production and grammar development were evaluated using a German language speech development test (SETK), reception of grammar test (TROG-D) and active vocabulary test (AWST-R). The data showed that children implanted under 12 months of age reached open-set monosyllabic word discrimination at an age of 24 months. LiP results improved over time, and children recognized 100% of words in the MTP test after 12 months. All children performed as well as or better than their hearing peers in speech production and grammar development. SETK showed that the speech development of these children was in general age appropriate. The data suggests that early hearing loss intervention benefits speech and language development and supports the trend towards early cochlear implantation. Furthermore, the data emphasizes the potential benefits associated with bilateral implantation.
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Report of cochlear implantation outcome in a case of Waardenburg syndrome. Int J Pediatr Otorhinolaryngol 2012; 76:761; author reply 761-2. [PMID: 22341475 DOI: 10.1016/j.ijporl.2012.01.025] [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: 10/25/2011] [Accepted: 01/18/2012] [Indexed: 11/22/2022]
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Silva MPD, Comerlatto Junior AA, Bevilacqua MC, Lopes-Herrera SA. Instruments to assess the oral language of children fitted with a cochlear implant: a systematic review. J Appl Oral Sci 2012; 19:549-53. [PMID: 22230986 PMCID: PMC3973453 DOI: 10.1590/s1678-77572011000600002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Accepted: 08/16/2011] [Indexed: 12/02/2022] Open
Abstract
The oral language development depends on the effective development of the hearing
system. In cases of children presenting with hearing loss, a cochlear implant is an
electronic device indicated to (re)habilitate the hearing function. Thus, it is of
paramount importance to assess and follow the oral language development of children
fitted with a cochlear implant (CI) to measure the effectiveness of the electronic
device and support the therapeutic planning of these children. Questions are
currently being raised about the instruments to assess the oral language of children
using a CI, and, seeking the answers, this systematic review aimed at surveying these
instruments. Searches were performed in three different databases utilizing six
different descriptors to select articles published from 2004 to 2009 that performed
an oral language assessment of children with a CI. Initially, 373 articles were
found, and, after the application of inclusion criteria, 47 articles were analyzed,
resulting in a survey of 74 instruments for oral language assessment, including
tests, questionnaires and inventories. In analyzing the articles, it was realized
that the studies included in this systematic review presented varied methodologies
and low levels of evidence, with a greater concentration of instruments assessing
receptive and expressive language, emphasizing the survey of the child's vocabulary
and questionnaires. Thus, it can be verified that other linguistic skills, such as
morphosyntactic, semantic, and narrative-pragmatic ones that are important in
structuring speech and language for the effectiveness of the child's speech, are not
being focused on. Just one of the instruments cited, a questionnaire, was specific
for the oral language assessment of children with cochlear implants.
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Hardonk S, Desnerck G, Loots G, Van Hove G, Van Kerschaver E, Sigurjónsdóttir HB, Vanroelen C, Louckx F. Congenitally deaf children's care trajectories in the context of universal neonatal hearing screening: a qualitative study of the parental experiences. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2011; 16:305-324. [PMID: 21367846 DOI: 10.1093/deafed/enq055] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The objective of this study is to examine the early care trajectories of congenitally deaf children from a parental perspective, starting with universal neonatal hearing screenings. The analysis using a three-dimensional care trajectory concept is aimed at developing a basic typology of postscreening care trajectories. Children with severe/profound hearing loss, registered in the Flanders' (Belgium) universal neonatal hearing screening program, born between 1999 and 2001. Thematic content analysis of qualitative data collected retrospectively from participant's parents. Two basic types of care trajectories emerged; based on differences in care-use in the phase of further diagnosis and related parental experiences. Subtypes resulted from events related to cochlear implantation. Five trajectory phases were identified: screening, further diagnosis, care and technology, cochlear implantation, and reduction of care and were characterized by specific parental experiences such as confusion, disbelief, disappointment, and uncertainty. Those experiences relate to care professionals' acts and communication and the child's functional evolution. Early care interventions could benefit from coordinated transition between phases, parent support throughout the care trajectory, and a broad approach to deafness in professionals' communication.
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Affiliation(s)
- Stefan Hardonk
- Faculty of Medicine and Pharmacy, Department of Medical Sociology, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussel, Belgium.
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Meinzen-Derr J, Wiley S, Grether S, Choo DI. Children with cochlear implants and developmental disabilities: a language skills study with developmentally matched hearing peers. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:757-767. [PMID: 21129916 DOI: 10.1016/j.ridd.2010.11.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 11/05/2010] [Accepted: 11/08/2010] [Indexed: 05/30/2023]
Abstract
The number of children receiving cochlear implants (CIs) with significant disabilities in addition to their deafness has increased substantially. Unfortunately, children with additional disabilities receiving CIs have largely been excluded from studies on cochlear implant outcomes. Thus limited data exists on outcomes in this population to guide pre-implant counseling for anticipated benefits. The study objectives were: (1) evaluate differences in post-cochlear implant language skills between children with cochlear implants and developmental disabilities and age/cognitively matched controls; (2) quantify possible discrepancies between language level and cognitive level. Fifteen children with a developmental disability who received a CI were matched 1:1 on nonverbal cognitive ability and age to hearing controls. Language was evaluated using Preschool Language Scale-IV and reported as language quotients. Multivariable mixed models for matched pairs analyzed differences in language levels between groups. No significant differences were seen between CI and control groups regarding insurance, maternal education, or family income level. Results of the multivariable models indicated that compared to matched controls, the CI group had significantly lower mean receptive (24.6 points, p=0.002) and mean expressive (21.9 points, p=0.001) language quotients after controlling for confounders such as number of therapies and weekly hours in therapy. Significant discrepancies between language level and cognitive level were seen among CI participants only. Compared to age- and cognitively matched controls, children with CIs had significantly lower language levels with delays disproportionate to their cognitive potential. Mechanisms behind this performance-functional gap need to be understood to deliver appropriate intervention strategies for this special population.
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Affiliation(s)
- Jareen Meinzen-Derr
- Division of Biostatistics, Cincinnati Children's Hospital Medical Center, Department of Otolaryngology, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
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A longitudinal study on auditory perception and speech intelligibility in deaf children implanted younger than 18 months in comparison to those implanted at later ages. Otol Neurotol 2011; 31:1261-7. [PMID: 20802371 DOI: 10.1097/mao.0b013e3181f1cde3] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to measure longitudinally the progress in the auditory performance and speech intelligibility of young deaf children implanted under the age of 18 months in comparison to those implanted after 18 months and to create normative data on these children implanted under 18 months. STUDY DESIGN : This is a retrospective longitudinal study based on data available at our centre 'KIDS-Hasselt-Belgium'. PATIENTS 52 deaf children who received a cochlear implant under the age of 18 months. METHODS LiP (Listening Progress profile) and CAP (Categories of Auditory Performance) were administered to measure auditory perception and SIR (Speech Intelligibility Rating) was used to measure speech intelligibility. Over a 4 year period, six assessments were made to monitor the auditory and speech development of the children: a pre-test before implantation and five post-tests at 6, 12, 24, 36 and 48 months after implantation. RESULTS Deaf children receiving cochlear implants before the age of 18 months show more rapid progress in auditory performance and speech intelligibility in comparison to children implanted at an older age. Their auditory performance and speech intelligibility also reach a higher level 4 years after implantation compared with children implanted later in life. DISCUSSION AND CONCLUSION This study shows encouraging results in the cochlear implantation of children under the age of 18 months. As demonstrated, using the LiP, CAP and SIR measures, children who receive a cochlear implant before the age of 18 months show, that at 3 to 4 years after implantation, significantly greater improvement is made in auditory perception and speech intelligibility than their later implanted peers, although there is a considerable variety in the outcomes.
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Gérard JM, Deggouj N, Hupin C, Buisson AL, Monteyne V, Lavis C, Dahan K, Gersdorff M. Evolution of communication abilities after cochlear implantation in prelingually deaf children. Int J Pediatr Otorhinolaryngol 2010; 74:642-8. [PMID: 20347162 DOI: 10.1016/j.ijporl.2010.03.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2010] [Accepted: 03/02/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study tries to evaluate different factors on communication ability outcomes in cochlear implanted children. METHODS Communication abilities are studied using the validated APCEI-scale based on five components of the language: cochlear implant acceptance, perceptive language performance, comprehension of the oral orders, expressive language and speech intelligibility. APCEI-scores were calculated every 6 months for the first 2 years, then yearly. The studied variables were: gender, social origin, preoperative residual hearing, age, aetiology of hearing loss, and associated disabilities. RESULTS Communication ability scores increased with high socioeconomic level, presence of residual hearing, younger patients when no residual hearing, connexin mutation related deafness, and absence of associated disabilities. No significant difference has been noted between both sexes. CONCLUSION Many different factors influence the evolution of communication abilities of cochlear implanted children. Investigating the cause of hearing loss, presence of associated disabilities and residual hearing before surgery may help to predict outcome and plan appropriate care to those children with negative predictive factors.
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Affiliation(s)
- Jean-Marc Gérard
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Catholic University of Louvain, University Hospital Saint-Luc, Av hippocrate 10, 1200 Brussels, Belgium.
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Chen X, Liu S, Liu B, Mo L, Kong Y, Liu H, Gong S, Han D, Zhang L. The effects of age at cochlear implantation and hearing aid trial on auditory performance of Chinese infants. Acta Otolaryngol 2010; 130:263-70. [PMID: 19680991 DOI: 10.3109/00016480903150528] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Most of the infants demonstrated rapid improvement in the three different auditory skills within the first year after switch-on. Infants undergoing hearing aid trial and habilitation demonstrated a significant positive effect on the development of auditory skills in comparison with infants without trial and habilitation. OBJECTIVE This paper aims to evaluate the auditory performance of infants of different age at cochlear implantation, emphasize the importance of the hearing aid trial and habilitation before implant, and provide baseline data of auditory development. METHODS In all, 259 infants with prelingually profound hearing loss participated in this study. The Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) was used to assess auditory skills in infants at different intervals. RESULTS The mean scores for the auditory skills improved significantly over time. The mean scores of three skills for each group at each interval were significantly different. The mean scores of the auditory skills were significantly superior for infants undergoing hearing aid trial and habilitation in comparison with those of infants without hearing aid trial and habilitation.
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Affiliation(s)
- Xueqing Chen
- Key Laboratory of Otolaryngology Head and Neck Surgery (Ministry of Education), Beijing Institute of Otolaryngology, Beijing 100005, China
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Validation of the LittlEARS((R)) Auditory Questionnaire in children with normal hearing. Int J Pediatr Otorhinolaryngol 2009; 73:1761-8. [PMID: 19836842 DOI: 10.1016/j.ijporl.2009.09.036] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Revised: 09/09/2009] [Accepted: 09/15/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVES With more children receiving cochlear implants during infancy, there is a need for validated assessments of pre-verbal and early verbal auditory skills. The LittlEARS Auditory Questionnaire is presented here as the first module of the LittlEARS test battery. The LittlEARS Auditory Questionnaire was developed and piloted to assess the auditory behaviour of normal hearing children and hearing impaired children who receive a cochlear implant or hearing aid prior to 24 months of age. This paper presents results from two studies: one validating the LittlEARS Auditory Questionnaire on children with normal hearing who are German speaking and a second validating the norm curves found after adaptation and administration of the questionnaire to children with normal hearing in 15 different languages. METHODS Scores from a group of 218 German and Austrian children with normal hearing between 5 days and 24 months of age were used to create a norm curve. The questionnaire was adapted from the German original into English and then 15 other languages to date. Regression curves were found based on parental responses from 3309 normal hearing infants and toddlers. Curves for each language were compared to the original German validation curve. RESULTS The results of the first study were a norm curve which reflects the age-dependence of auditory behaviour, reliability and homogeneity as a measure of auditory behaviour, and calculations of expected and critical values as a function of age. Results of the second study show that the regression curves found for all the adapted languages are essentially equal to the German norm curve, as no statistically significant differences were found. CONCLUSIONS The LittlEARS Auditory Questionnaire is a valid, language-independent tool for assessing the early auditory behaviour of infants and toddlers with normal hearing. The results of this study suggest that the LittlEARS Auditory Questionnaire could also be very useful for documenting children's progress with their current amplification, providing evidence of the need for implantation, or highlighting the need for follow-up in other developmental areas.
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Duchesne L, Sutton A, Bergeron F. Language achievement in children who received cochlear implants between 1 and 2 years of age: group trends and individual patterns. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2009; 14:465-485. [PMID: 19461113 DOI: 10.1093/deafed/enp010] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This study examined receptive and expressive vocabulary and grammar achievement of French-speaking children (n = 27) who received a cochlear implant (CI) between the age of 1 and 2. Standardized measures of language achievement were administered and the language levels attained by children with CIs were compared with that of the normative sample of same-age hearing peers for each measure. As a group, children exhibited language levels within normal limits in all standardized language measures. Examination of individual patterns revealed four different language profiles ranging from normal language levels in all domains to general language delay. Half the participants displayed language levels on par with similar-age peers at the word level; less than half the children obtained average performance at the sentence level. In three of these profiles, comprehension of sentences was impaired. Moreover, the age at implantation was not associated with language achievement. Findings suggest that receiving a CI between the age of 1 and 2 years does not ensure that language abilities will be within normal limits after up to 6 years of experience with the implant.
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Valencia DM, Rimell FL, Friedman BJ, Oblander MR, Helmbrecht J. Cochlear implantation in infants less than 12 months of age. Int J Pediatr Otorhinolaryngol 2008; 72:767-73. [PMID: 18403026 DOI: 10.1016/j.ijporl.2008.02.009] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2007] [Revised: 02/01/2008] [Accepted: 02/04/2008] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Infants are diagnosed with severe to profound hearing loss at an earlier age due to the advent of universal newborn hearing screening. This offers the opportunity to provide intervention in the form of cochlear implantation at an earlier age than was previously possible. The purpose of this investigation is to evaluate the risk of cochlear implant surgery in children less than 12 months of age. DESIGN Retrospective review of children who underwent cochlear implantation before 12 months of age. SETTING Patients were identified from a database of pediatric cochlear implant patients at a tertiary care center. All patients were diagnosed with severe to profound hearing loss by otoacoustic emission and auditory brainstem response. Follow-up ranged from 2 months to 5 years. RESULTS Fourteen of 15 patients had full insertions of the electrode hardware. Less than full insertion and post-operative CSF otorrhea occurred in one patient with severe cochlear abnormalities. There were no other perioperative surgical complications. The average speech detection threshold was 27.6 dB (20-45 dB) at approximately 1-3 months post-stimulation and 25 dB (15-30 dB) at approximately 5-7 months. CONCLUSION In our experience, we feel cochlear implantation is safe for infants as young as 6 months of age. The current standard at our institution is to implant by 7 months of age for prelingual deafness as opposed to waiting additional time until 12 months of age before the brain is presented with speech.
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Affiliation(s)
- David M Valencia
- Department of Otolaryngology, University of Minnesota, MN, United States.
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Yong-xin L, Shuang L, De-min H. Research Advances in Post-Operative Rehabilitation Following Cochlear Implant. J Otol 2007. [DOI: 10.1016/s1672-2930(07)50019-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Tait M, De Raeve L, Nikolopoulos TP. Deaf children with cochlear implants before the age of 1 year: comparison of preverbal communication with normally hearing children. Int J Pediatr Otorhinolaryngol 2007; 71:1605-11. [PMID: 17692931 DOI: 10.1016/j.ijporl.2007.07.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2007] [Revised: 07/06/2007] [Accepted: 07/07/2007] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To compare preverbal behaviors of deaf children implanted under 1 year of age with age-matched hearing children. METHODS The study assessed 20 children; 10 deaf children implanted under 1 year of age and 10 normally hearing children of the same age. Preverbal skills were measured before, 6 months, and 1 year after implantation, using Tait Video Analysis that is able to predict later speech outcomes in young implanted children. RESULTS Regarding vocal turns, the normally hearing group outperformed the implanted group although the latter children became quite vocal, nearly 60% of their turns being taken in this way. The mean vocal autonomy in implanted children, 1 year after implantation, was very close to the respective of hearing children (38.5 versus 43.5). Regarding the non-looking vocal turns, by the 12-month interval, hearing children had somewhat higher scores than implanted children, but the difference was not significant and the increase in implanted children was much higher (40-fold increase versus 4-fold increase). However, implanted children were more likely to use silent communication than hearing children, although gestural turns were decreasing with time. CONCLUSIONS The small numbers in this study, although two of the largest European cochlear implant centers were combined to recruit such young implantees, led us to be cautious in interpreting the results. However, it seems that in deaf implanted children under 1 year of age, some preverbal communication behaviors are developing to an extent (although at a somewhat lower level) not significantly different from those of age-matched normally hearing children.
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Affiliation(s)
- M Tait
- The Ear Foundation, Nottingham, United Kingdom
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Priwin C, Jönsson R, Hultcrantz M, Granström G. BAHA in children and adolescents with unilateral or bilateral conductive hearing loss: a study of outcome. Int J Pediatr Otorhinolaryngol 2007; 71:135-45. [PMID: 17092570 DOI: 10.1016/j.ijporl.2006.09.014] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2006] [Revised: 09/27/2006] [Accepted: 09/30/2006] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Bilateral BAHAs in adults with bilateral hearing loss (BHL) have proven to be superior to unilateral fitting, in both audiologically measurements and in overall patient satisfaction. There have been no similar studies in children. Furthermore, a recent meta-analysis of children with unilateral hearing loss (UHL) has shown numerous negative consequences. The objectives of the study were to investigate whether fitting of bilateral BAHAs in children with conductive BHL give additional hearing benefits, to investigate the effects of unilateral hearing aids in children with conductive UHL, and to identify different aspects of auditory problems in children with conductive UHL or BHL. STUDY DESIGN This was a prospective study involving 22 children with either conductive UHL (unaided or with unilateral hearing aid) or conductive BHL (with unilateral or bilateral BAHAs) and 15 controls. METHODS Baseline audiometry, tone thresholds in a sound field, speech recognition in noise and sound localization were tested without, and with unilateral and bilateral hearing aids. Two questionnaires, MAIS & MUSS and IOI-HA, were completed. RESULTS Two problem areas were identified in the children with hearing impairment: in reactions to sounds and in intelligibility of speech. An additional BAHA in the children with BHL resulted in a tendency to have improved hearing in terms of better sound localization and speech recognition in noise. Fitting of unilateral hearing aids in the children with UHL gave some supplementary benefit in terms of better speech recognition in noise but no positive effect on ability to localize sound could be detected. Even so, all children fitted with hearing aids - either unilaterally or bilaterally - reported a positive outcome with their devices in the self-assessment questionnaire. CONCLUSIONS Children with either UHL or BHL displayed several problems within the hearing domain. Fitting of bilateral BAHAs in children with BHL and of a single-sided hearing aid in children with UHL appears to have some supplementary audiological benefits and also renders high patient satisfaction. In order to investigate the possible supplementary effects of hearing aids, a 3-month trial of BAHA on Softband, either unilaterally or bilaterally, may be of value in children with conductive UHL or BHL, respectively.
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Affiliation(s)
- Claudia Priwin
- Department of Otolaryngology & Head and Neck Surgery, Karolinska Institute, Stockholm, Sweden.
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Developmental delay and outcomes in paediatric cochlear implantation: implications for candidacy. Int J Pediatr Otorhinolaryngol 2006; 70:1593-600. [PMID: 16814874 DOI: 10.1016/j.ijporl.2006.04.008] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2006] [Revised: 04/23/2006] [Accepted: 04/25/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Criteria for paediatric cochlear implant candidacy continue to evolve, as research indicates an increasingly broad range of children for whom the procedure can produce benefit. Children with difficulties in addition to their deafness, or global developmental delay, are not routinely excluded. The aim of this study is to explore the association between developmental delay in young paediatric cochlear implant candidates and progress with the device. MATERIALS AND METHODS The study is a retrospective case series analysis of 32 children, aged between 1.2 and 2.8 years at pre-implant assessment. Children were assessed using the Schedule of Growing Skills II and IT-MAIS before implantation. Progress in speech perception and Speech Intelligibility was monitored using the E2L toy test and Speech Intelligibility Rating (SIR), respectively, 1 and 2 years after switch-on. RESULTS Data were subjected to regression analyses, with either the E2L or SIR as the outcome variables, and variables derived from the Schedule of Growing Skills II (general development and cognitive functioning), IT-MAIS, age at switch-on and average aided hearing loss pre-implant as the predictor variables. In each analysis the strongest (and statistically significant) predictors of speech perception and Speech Intelligibility were the measures of general development and cognitive functioning, accounting for around 40% of the variance in outcomes. CONCLUSION This study indicates the value of routinely assessing the general development of young paediatric cochlear implant candidates, as part of the pre-implant decision-making process. Significant developmental delay is predictive of poor outcomes, but children with a mild delay do make appreciable progress. Developmental assessment of young deaf children is therefore important in terms of candidacy decisions and counselling parents regarding potential benefit from a cochlear implant.
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Colletti V, Carner M, Miorelli V, Guida M, Colletti L, Fiorino FG. Cochlear Implantation at under 12 months: Report on 10 Patients. Laryngoscope 2005; 115:445-9. [PMID: 15744155 DOI: 10.1097/01.mlg.0000157838.61497.e7] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES There is growing evidence that early application of a cochlear implant in children affected by profound congenital hearing loss is of paramount importance for the development of an adequate auditory performance and language skills. For these reasons and as a result of advances in audiologic diagnosis and an enhanced awareness of the safety of cochlear implants, the age of implantation has substantially decreased over recent years. Children aged as little as 12 months are now being implanted in some centers. On the basis of our experience with very young children, we believe that the date of implantation may be further reduced to only 4 to 6 months of age. STUDY DESIGN Over the period from November 1998 to April 2004, 103 children have been fitted with cochlear implants and 11 with auditory brainstem implants in our department, including 65 children aged below 3 years. The present study focuses on 10 children aged less than 12 months fitted with cochlear implants from November 1998 to December 2003. METHODS The children's ages ranged from 4 to 11 (mean 9.5) months. Five were males and five females. All received a Nucleus CI 24 M. Postoperative auditory performance, as evaluated at the latest follow-up, was based on the category of auditory performance (CAP). The results obtained in these 10 children were compared with those obtained with cochlear implants in children belonging to older age brackets. The criteria used to assess speech performance were onset of babbling onset and babbling spurt, and the results observed were compared with those of a control group of 10 normally hearing children. RESULTS Surgery was uneventful, and no immediate or delayed complications were encountered. Auditory performance was seen to increase as function of early age of implantation and length of implant use. All 10 children had a CAP score of 3 within 6 months of cochlear implant activation. The onset of babbling occurred very early (i.e., within 1 to 3 months of activation of the implant in all 10 patients), regardless of age at implantation, whereas the babbling spurt was recorded at times ranging from 3 to 5 months after implant activation. The positive impact of early implantation on babbling was clearly shown by the fact that the earlier the activation of the cochlear implant, the closer the results were to the outcomes of normally hearing children. CONCLUSIONS We encourage very early implantation to facilitate a series of developmental processes occurring in the critical period of initial language acquisition. The indices we used in the present study (i.e., CAP and babbling) suggest that early cochlear implantation tends to yield normalization of audio-phonologic parameters, which enables us to consider the performance of children implanted very early as being similar to that of their normally hearing peers.
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