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Meehan S, Adank ML, van der Schroeff MP, Vroegop JL. A systematic review of acoustic change complex (ACC) measurements and applicability in children for the assessment of the neural capacity for sound and speech discrimination. Hear Res 2024; 451:109090. [PMID: 39047579 DOI: 10.1016/j.heares.2024.109090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 07/11/2024] [Accepted: 07/16/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE The acoustic change complex (ACC) is a cortical auditory evoked potential (CAEP) and can be elicited by a change in an otherwise continuous sound. The ACC has been highlighted as a promising tool in the assessment of sound and speech discrimination capacity, and particularly for difficult-to-test populations such as infants with hearing loss, due to the objective nature of ACC measurements. Indeed, there is a pressing need to develop further means to accurately and thoroughly establish the hearing status of children with hearing loss, to help guide hearing interventions in a timely manner. Despite the potential of the ACC method, ACC measurements remain relatively rare in a standard clinical settings. The objective of this study was to perform an up-to-date systematic review on ACC measurements in children, to provide greater clarity and consensus on the possible methodologies, applications, and performance of this technique, and to facilitate its uptake in relevant clinical settings. DESIGN Original peer-reviewed articles conducting ACC measurements in children (< 18 years). Data were extracted and summarised for: (1) participant characteristics; (2) ACC methods and auditory stimuli; (3) information related to the performance of the ACC technique; (4) ACC measurement outcomes, advantages, and challenges. The systematic review was conducted using PRISMA guidelines for reporting and the methodological quality of included articles was assessed. RESULTS A total of 28 studies were identified (9 infant studies). Review results show that ACC responses can be measured in infants (from < 3 months), and there is evidence of age-dependency, including increased robustness of the ACC response with increasing childhood age. Clinical applications include the measurement of the neural capacity for speech and non-speech sound discrimination in children with hearing loss, auditory neuropathy spectrum disorder (ANSD) and central auditory processing disorder (CAPD). Additionally, ACCs can be recorded in children with hearing aids, auditory brainstem implants, and cochlear implants, and ACC results may guide hearing intervention/rehabilitation strategies. The review identified that the time taken to perform ACC measurements was often lengthy; the development of more efficient ACC test procedures for children would be beneficial. Comparisons between objective ACC measurements and behavioural measures of sound discrimination showed significant correlations for some, but not all, included studies. CONCLUSIONS ACC measurements of the neural capacity to discriminate between speech and non-speech sounds are feasible in infants and children, and a wide range of possible clinical applications exist, although more time-efficient procedures would be advantageous for clinical uptake. A consideration of age and maturational effects is recommended, and further research is required to investigate the relationship between objective ACC measures and behavioural measures of sound and speech perception for effective clinical implementation.
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Affiliation(s)
- Sarah Meehan
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.
| | - Marloes L Adank
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Marc P van der Schroeff
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Jantien L Vroegop
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
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Gargeshwari A, Krishnan A, Delgado RE. Quick Estimation of Minimum Hearing Levels Using a Binaural Multifrequency Stimulus Paradigm: Proof of Concept. Ear Hear 2024:00003446-990000000-00292. [PMID: 38825740 DOI: 10.1097/aud.0000000000001535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
OBJECTIVES Objective estimation of minimum hearing levels using auditory brainstem responses (ABRs) elicited by single frequency tone-bursts presented monaurally is currently considered the gold standard. However, the data acquisition time to estimate thresholds (for both ears across four audiometric frequencies) using this method usually exceeds the sleep time (ranging between 35 and 49 minutes) in infants below 4 months, thus providing incomplete information of hearing status which in turn delays timely clinical intervention. Alternate approaches using faster rate, or tone-burst trains have not been readily accepted due to additional hardware and software requirements. We propose here a novel binaural multifrequency stimulation paradigm wherein several stimuli of different frequencies are presented binaurally in an interleaved manner. The rationale here is that the proposed paradigm will increase acquisition efficiency, significantly reduce test time, and improve accuracy by incorporating an automatic wave V detection algorithm. It is important to note that this paradigm can be easily implemented in most commercial ABR systems currently used by most clinicians. DESIGN Using this binaural multifrequency paradigm, ear specific ABRs were recorded in 30 normal-hearing young adults to both tone-bursts, and narrow-band (NB) iChirps at 500, 1000, 2000, and 4000 Hz. Comparison of ABRs elicited by tone-bursts and narrow-band chirps allowed us to determine if NB iChirps elicited a more robust wave V component compared with the tone-bursts. ABR data were characterized by measures of minimum hearing levels; wave V amplitude; and response detectability for two electrode configurations (high forehead-C7; and high forehead-linked mastoids). RESULTS Consistent with the research literature, wave V response amplitudes were relatively more robust for NB iChirp stimuli compared with tone-burst stimuli. The easier identification and better detectability of wave V for the NB iChirps at lower stimulus levels contributed to their better thresholds compared with tone-burst elicited responses. It is important to note that binaural multifrequency hearing levels close to minimum hearing levels were determined in approximately 22 minutes using this paradigm-appreciably quicker than the 45 to 60 minutes or longer time required for threshold determination using the conventional single frequency method. CONCLUSIONS Our novel and simple paradigm using either NB iChirps or tone-bursts provides a reliable method to rapidly estimate the minimum hearing levels across audiometric frequencies for both ears. Incorporation of an automatic wave V detection algorithm increases objectivity and further reduce test time and facilitate early hearing identification and intervention.
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Affiliation(s)
- Aditi Gargeshwari
- Department of Speech Language Hearing Sciences, Auditory Electrophysiology Laboratory, Purdue University, West Lafayette, Indiana, USA
| | - Ananthanarayan Krishnan
- Department of Speech Language Hearing Sciences, Auditory Electrophysiology Laboratory, Purdue University, West Lafayette, Indiana, USA
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Roque Reis LS, Gani K, André, Peres C, Nunes G, Santos R, O'Neill A, Escada P. [Adaptation and Validation for European Portuguese of the Auditory Performance Categories-II and Infant-Toddler Meaningful Auditory Integration Scale for Children with Cochlear Implant]. ACTA MEDICA PORT 2024; 37:334-341. [PMID: 38498908 DOI: 10.20344/amp.20169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/07/2023] [Indexed: 03/20/2024]
Abstract
INTRODUCTION The Categories of Auditory Performance II (CAP-II) scale and the Infant-Toddler Meaningful Audit Integration Scale (IT-MAIS) are simple and quick questionnaires that allow assessment of the auditory performance of children with cochlear implant (CI). The aim of this study was to translate, adapt and validate the European Portuguese version of the CAP-II and IT-MAIS scales. METHODS A total of 85 participants completed the European Portuguese version of the CAP-II and IT-MAIS questionnaires, of which 45 were parents of children with pediatric cochlear implants (9.84 ± 4.22 years) and another 40 were parents of children with normal hearing (8.35 ± 3.56 years). Inter-rater reproducibility, test-retest reproducibility, comparison of study group versus control group results, internal consistency and correlation of the new scales were evaluated. RESULTS The CAP-II and IT-MAIS scales showed high reliability and reproducibility, respectively, with an intraclass correlation coefficient (ICC) of 0.979 (p < 0.001) and a Spearman's correlation of 0.924 for the CAP-II scale, and an ICC of 0.932 (p < 0.001) and Spearman's correlation coefficient of 0.732 for the IT-MAIS scale. The IT-MAIS and CAP-II versions showed strong internal consistency (Cronbach's α coefficient value of 0.887 for the CAP-II scale and Spearman's positive correlation of 0.677 for the IT-MAIS scale, respectively) and allowed for the differentiation between children with normal hearing and post-implantation children (p = 0.001 and p < 0.001 respectively for each of the scales). There was no association between parental education and the results on the scales (p > 0.05). CONCLUSION The findings demonstrated that the European Portuguese version of these scales is a valid and reliable tool for assessing auditory performance in European Portuguese-speaking children with hearing loss.
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Affiliation(s)
- Luí S Roque Reis
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
| | - Kaamil Gani
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
| | - André
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
| | - Carlota Peres
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa. Portugal
| | - Gonçalo Nunes
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa. Portugal
| | - Ricardo Santos
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
| | - Assunção O'Neill
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
| | - Pedro Escada
- Serviço de Otorrinolaringologia. Hospital Egas Moniz. Centro Hospitalar de Lisboa Ocidental (CHLO). Lisboa; NOVA Medical School. Faculdade de Ciências Médicas. Lisboa. Portugal
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Tercyak S, Evans Z, Nahas G, Behzadpour H, Preciado D, Reilly B. Pediatric cochlear implantation: Early surgical intervention and parental quality of life. Int J Pediatr Otorhinolaryngol 2024; 177:111867. [PMID: 38290273 DOI: 10.1016/j.ijporl.2024.111867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/18/2023] [Accepted: 01/10/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVES Pediatric cochlear implantation (CI) provides sound perception to children with significant sensorineural hearing loss and, despite its challenging process, early implantation can enhance children's speech/language outcomes and potentially improve parental quality of life (PQoL). This study aims to examine parental perspectives on quality of life and parenting children with CI. METHODS This study combined retrospective chart review and parent reported outcomes. Data were abstracted from medical charts of 85 children who underwent CI between 2016 and 2022 at a tertiary pediatric hospital. Parents were administered the Acceptance and Action Questionnaire (AAQ-MCHL), an 8-item self-report assessment of quality of life for parents of children with CI. Multivariate linear regression analyses examined clinical factors associated with PQoL scores. RESULTS Parents whose children were implanted at less than two years of age reported significantly higher PQoL, indicated by lower AAQ scores, with a mean AAQ-MCHL of 7.6 + 5.7. In contrast, implantation at age >2 years yielded a mean AAQ-MCHL of 16.2 + 9.6. Parents interviewed within one year post-surgery reported lower PQoL, with a mean AAQ-MCHL of 12.3 + 8.8 compared to those interviewed after one year, with 20.5 + 10.4. CONCLUSION Early identification of profound hearing loss in children, coupled with early surgical CI, may be associated with higher parental quality of life. The beneficial outcomes appear to be potentiated over time. Further research is essential to fully comprehend the impact of CI on the quality of life of children and their parents.
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Affiliation(s)
- Samuel Tercyak
- Department of Otolaryngology, Children's National Hospital, United States
| | - Zoe Evans
- Department of Otolaryngology, Children's National Hospital, United States
| | - Gabriel Nahas
- Department of Otolaryngology, Children's National Hospital, United States
| | | | - Diego Preciado
- Department of Otolaryngology, Children's National Hospital, United States
| | - Brian Reilly
- Department of Otolaryngology, Children's National Hospital, United States.
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Farmani E, Fekar Gharamaleki F, Nazari MA. Challenges and opportunities of tele-speech therapy: Before and during the COVID-19 pandemic. J Public Health Res 2024; 13:22799036231222115. [PMID: 38333616 PMCID: PMC10851737 DOI: 10.1177/22799036231222115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/06/2023] [Indexed: 02/10/2024] Open
Abstract
In 2020, with the onset of the COVID-19 pandemic, the treatment and rehabilitation process faced problems and challenges. One of the most efficient therapy approaches in this period was telerehabilitation. Telepractice in speech therapy presents many challenges and opportunities. In this article, we review published articles up to June 2023 and summarize the challenges and opportunities of the COVID-19 pandemic for speech therapy. Researchers and clinicians have found that tele-speech therapy is an effective tool for improving access to high-quality services and a viable mechanism for delivering speech and language interventions. The results of teletherapy or telepractice during the COVID-19 pandemic were divided into opportunities and challenges. Speech therapy has moved toward telerehabilitation to improve treatment competence during the pandemic. Finally, teletherapy methods were more suitable for speech and language pathology.
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Affiliation(s)
- Elahe Farmani
- Department of Speech Therapy, Iran University of Medical Science, Tehran, Iran
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Raza AF, Aryal S, Prabhu P. Indicators for cochlear implantation in children with auditory neuropathy spectrum disorder: A systematic review. Int J Pediatr Otorhinolaryngol 2023; 174:111737. [PMID: 37748323 DOI: 10.1016/j.ijporl.2023.111737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE ANSD refers to a group of auditory diseases demonstrating intact outer hair cells and desynchronized neural firings of the auditory nerve. A cochlear implant is a promising intervention strategy for severe to profound sensorineural hearing loss (SNHL). However, due to its variable outcomes in children with ANSD, a consensus has yet to be reached on its performance. This study aimed to review the literature to determine the efficacy of cochlear implants in children with ANSD and to determine prognostic indicators. The study identifies the pre-operative and post-operative predictors of success for CI in children with ANSD. METHOD The review was carried out using PRISMA guidelines. This resulted in 9630 topic-related articles. Among these, 17 articles met the inclusion and exclusion criteria that were included for the study. The quality and potential risks associated with each article were evaluated using the quality impact assessment protocol (QUIPS) tool. RESULTS A review of 17 articles was conducted to highlight these predictors. Most selected studies included case reports, case series, cohorts, and comparisons between children with ANSD and SNHL. Assessment of study quality reported an overall low risk of bias. The overall result showed cochlear implant would be an effective option for children with ANSD. However, there are specific prognostic indicators about which clinician needs to be aware before recommending CI for children with ANSD. Our review study identified a set of pre-operative and post-operative indicators that predicted speech and auditory performance and gave some insight into the lesion site in ANSD individuals. CONCLUSION This review concludes CI is an effective option for children with ANSD. However, before recommending CI, a detailed assessment is required from different perspectives, which could serve as predictors of postoperative outcomes. This review highlights the need to include more precise tools, such as genetic testing to describe the lesion site to choose the most appropriate management strategy for children with ANSD. Knowledge about the prognostic indicators and the effective assessment protocols would help clinicians for the better candidacy selection.
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Affiliation(s)
- Aiza Fatima Raza
- All India Institute of Speech and Hearing, Mysore, 570006, India
| | - Sajana Aryal
- All India Institute of Speech and Hearing, Mysore, 570006, India.
| | - Prashanth Prabhu
- All India Institute of Speech and Hearing, Mysore, 570006, India
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Spitzer ER, Waltzman SB. Cochlear implants: the effects of age on outcomes. Expert Rev Med Devices 2023; 20:1131-1141. [PMID: 37969071 DOI: 10.1080/17434440.2023.2283619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/10/2023] [Indexed: 11/17/2023]
Abstract
INTRODUCTION Cochlear implants (CIs) provide access to sound for children and adults who do not receive adequate benefit from hearing aids. Age at implantation is known to affect outcomes across the lifespan. AREAS COVERED The effects of age on CI outcomes are examined for infants, children, adolescents, and older adults. A variety of outcome measures are considered, including speech perception, language, cognition, and quality of life measures. EXPERT OPINION/COMMENTARY For those meeting candidacy criteria, CIs are beneficial at any age. In general, younger age is related to greater benefit when considering pre-lingual deafness. Other factors such as additional disabilities, may mitigate this effect. Post-lingually deafened adults demonstrate similar benefit regardless of age, though the oldest individuals (80+) may see smaller degrees of improvement from preoperative scores. Benefit can be measured in many ways, and the areas of greatest benefit may vary based on age: young children appear to see the greatest effects of age at implantation on language measures, whereas scores on cognitive measures appear to be most impacted for the oldest population. Future research should consider implantation at extreme ages (5-9 months or > 90 years), unconventional measures of CI benefit including qualitative assessments, and longitudinal designs.
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Affiliation(s)
- Emily R Spitzer
- Department of Otolaryngology-Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Susan B Waltzman
- Department of Otolaryngology-Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
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Moncrieff D, Auld R, Johnston D, Wirt T. Dichotic listening deficits in children with hearing loss. Int J Pediatr Otorhinolaryngol 2023; 168:111521. [PMID: 37031658 DOI: 10.1016/j.ijporl.2023.111521] [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: 10/29/2022] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 04/11/2023]
Abstract
PURPOSE This correlational study compared dichotic listening among children with significant hearing loss to typically developing children and children clinically assessed for auditory processing disorder. METHOD Recorded versions of two dichotic tests were delivered under earphones or in the sound field for children using amplification. Individual ear scores and interaural asymmetry were compared to normative data. Matched deficit patterns from both tests were identified, ranked for severity of deficit, and compared across groups. Relationships between dichotic scores and factors related to amplification were investigated in the children with hearing loss. RESULTS Dichotic scores were significantly poorer among children with hearing loss without the large interaural asymmetries seen in children assessed clinically for auditory processing problems. Device type and age of implantation had no effect on scores; non-dominant ear scores on the digits test were significantly correlated to age of device use in the left ear and duration of device use in the right ear. Non-dominant ear scores with digits were also significantly correlated with bilateral word recognition. CONCLUSIONS Poor dichotic perception in children with significant hearing losses may be related to the use of recorded test materials, immature skills in attention and working memory, or other factors that contribute to development of vocabulary and language. These weaknesses may interfere with successful mainstream educational placement in these children. Assessment of dichotic performance in this population could lead to deficit-specific interventions that may improve outcomes and enhance educational opportunities for children with hearing loss.
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Affiliation(s)
- Deborah Moncrieff
- School of Communication Sciences and Disorders, University of Memphis, Memphis, TN, USA.
| | - Ruth Auld
- DePaul School for Hearing and Speech, Pittsburgh, PA, USA
| | | | - Tessa Wirt
- DePaul School for Hearing and Speech, Pittsburgh, PA, USA
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Alkhamra R, Alkhamra H. Assessing school readiness in children with cochlear implants using an Arabic language-based test. SPEECH, LANGUAGE AND HEARING 2023. [DOI: 10.1080/2050571x.2023.2178760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- Rana Alkhamra
- Department of Hearing and Speech Sciences, University of Jordan, Amman, Jordan
| | - Hatem Alkhamra
- Department of Special Education, University of Jordan, Amman, Jordan
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DiFabio D, Moodie S, O’Hagan R, Pardal S, Glista D. Barriers and facilitators to paediatric caregivers' participation in virtual speech, language, and hearing services: A scoping review. Digit Health 2023; 9:20552076231216684. [PMID: 38033515 PMCID: PMC10687955 DOI: 10.1177/20552076231216684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 12/02/2023] Open
Abstract
Purpose Virtual care-related technologies are transforming the way in which health services are delivered. A growing number of studies support the use of virtual care in the field of audiology and speech-language pathology; however, there remains a need to identify and understand what influences caregiver participation within the care that is virtual and family-focused. This review aimed to identify, synthesize, and summarize the literature around the reported barriers and facilitators to caregiver participation in virtual speech/hearing assessment and/or intervention appointments for their child. Methods A scoping review was conducted following the Joanna Briggs Institute manual for evidence synthesis. A search was conducted using six databases including MEDLINE, CINAHL, SCOPUS, ERIC, Nursing and Allied Health, and Web of Science to collect peer-reviewed studies of interest. Data was extracted according to a protocol published on Figshare, outlining a predefined data extraction form and search strategy. Results A variety of service delivery models and technology requirements were identified across the 48 included studies. Caregiver participation was found to vary across levels of attendance and involvement according to eight categories: Attitudes, child behavioral considerations, environment, opportunities, provider-family relationship, role in care process, support, and technology. Conclusions This review presents a description of the key categories reported to influence caregiver participation in virtual care appointments. Future research is needed to explore how the findings can be used within family-centered care models to provide strategic support benefiting the use and outcomes of virtual care.
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Affiliation(s)
- Danielle DiFabio
- School of Health and Rehabilitation Sciences, Western University, London, ON, Canada
| | - Sheila Moodie
- School of Health and Rehabilitation Sciences, Western University, London, ON, Canada
- The National Centre for Audiology, Western University, London, ON, Canada
- The School of Communication Sciences and Disorders, Western University, London, ON, Canada
| | - Robin O’Hagan
- The National Centre for Audiology, Western University, London, ON, Canada
| | - Simrin Pardal
- School of Health Studies, Western University, London, ON, Canada
| | - Danielle Glista
- School of Health and Rehabilitation Sciences, Western University, London, ON, Canada
- The National Centre for Audiology, Western University, London, ON, Canada
- The School of Communication Sciences and Disorders, Western University, London, ON, Canada
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Noel A, Manikandan M, Kumar P. Efficacy of auditory verbal therapy in children with cochlear implantation based on auditory performance - A systematic review. Cochlear Implants Int 2023; 24:43-53. [PMID: 36416476 DOI: 10.1080/14670100.2022.2141418] [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: 11/24/2022]
Abstract
This systematic review focuses on the efficacy of auditory verbal therapy (AVT) in children with cochlear implants based on their auditory performance. The results presented are based on research findings from 2010 to 2021. The systematic review was designed based on the Popular Reporting Systems for the Systematic Review and Analysis of Meta-Analysts (PRISMA), the 2020 revised version, and the Critical Evidence for Clinical Evidence (CATE) checklist. Specific keywords were chosen based on the formulated research question and searched on the following search engines: Google Scholar, Microsoft Academic, PubMed, Semantic Scholar, Cochrane, Science Direct, and BASE. All the searched articles were analysed based on specific exclusion criteria. The results revealed an important progression based on the auditory performance among children with cochlear implantation who received habilitation. The studies highlight that younger the age at implantation better the auditory performance and this may be necessary to allow at least relatively normal organization of auditory pathways in pre-lingual children with hearing impairment. Therefore, regular revitalization of aural-verbal rehabilitation and speech and language therapy is essential for younger children with hearing impairment to achieve the highest level of hearing function. This systematic review highlights importance of assessment of the auditory performance to be considered in the test battery while evaluating children with CI before and after habilitation along with AVT.
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Affiliation(s)
- Augustina Noel
- Department of Audiology, All India Institute of Speech and Hearing, Manasagangotri, Mysore, 570006, India
| | - Manju Manikandan
- Department of Audiology, All India Institute of Speech and Hearing, Manasagangotri, Mysore, 570006, India
| | - Prawin Kumar
- Department of Audiology, All India Institute of Speech and Hearing, Manasagangotri, Mysore, 570006, India
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Glaubitz C, Geiss KT, Hoppe U. [Word production in children with cochlear implant based on chronological age and hearing age]. Laryngorhinootologie 2022; 101:886-895. [PMID: 36055256 DOI: 10.1055/a-1925-7757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND For congenitally deaf children, an early bilateral provision with cochlear implant (CI) is a favourable condition for language acquisition. The objective of the present study was to determine the word production in CI children. The focus was on a comparison of chronological age and hearing age performance and on the evaluation of potential effects of multilingualism, additional disabilities and age at provision. METHODS The data of 62 children with bilateral CI (age at provision in months M=12,1; SD=6,2) were retrospectively analysed. Vocabulary was assessed by the test Aktiver Wortschatztest für 3- bis 5-jährige Kinder - Revision and compared for chronological age and hearing age. Group comparisons and correlation analysis was conducted regarding multilingualism, additional disabilities and age at provision. RESULTS The cohort performed significantly better when referenced to hearing age: level were within or above the norm in more than 50%; referenced to chronological age in around 37%. The descriptive performance differences for multilingualism and additional disabilities were only significant for children with both characteristics. Performance of monolingual children without additional disabilities was not significantly associated with age at provision. CONCLUSION CI children may achieve an adequate expressive vocabulary at the age of 3 to 5 years. Multilingualism and additional disabilities seem to be particular challenges for CI children and need a more precise definition in further studies. The use of both chronological and hearing age as reference marks allows a differentiated assessment of the language status. This may lead to benefits in therapeutic interventions and parent councelling.
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Affiliation(s)
- Cynthia Glaubitz
- Cochlear-Implant-Centrum CICERO, Universitätsklinikum Erlangen Hals-Nasen-Ohrenklinik Kopf- und Halschirurgie, Erlangen, Germany
| | - Katrin T Geiss
- Cochlear-Implant-Centrum CICERO, Universitätsklinikum Erlangen Hals-Nasen-Ohrenklinik Kopf- und Halschirurgie, Erlangen, Germany
| | - Ulrich Hoppe
- Cochlear-Implant-Centrum CICERO, Universitätsklinikum Erlangen Hals-Nasen-Ohrenklinik Kopf- und Halschirurgie, Erlangen, Germany
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Urík M, Šikolová S, Hošnová D, Kruntorád V, Bartoš M, Jabandžiev P. Long-Term Device Satisfaction and Safety after Cochlear Implantation in Children. J Pers Med 2022; 12:jpm12081326. [PMID: 36013275 PMCID: PMC9410025 DOI: 10.3390/jpm12081326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 12/02/2022] Open
Abstract
(1) Objectives: For full benefit in children implanted with a cochlear implant (CI), wearing the device all waking hours is necessary. This study focuses on the relationship between daily use and audiological outcomes, with the hypothesis that frequent daily device use coincides with high device satisfaction resulting in better functional gain (FG). Confounding factors such as implantation age, device experience and type of device were considered. (2) Results: Thirty-eight CI children (65 ears) were investigated. In total, 76.92% of the children were using their device for >12 h per day (h/d), 18.46% for 9−12 h/d, the remaining for 6−9 h/d and one subject reported 3 h/d. The revision rate up to the 90-month follow-up (F/U) was 4.6%. The mean FG was 59.00 ± 7.67 dB. The Audio Processor Satisfaction Questionnaire (APSQ) separated for single unit (SU) versus behind the ear (BTE) devices showed significantly better results for the latter in terms of wearing comfort (WC) (p = 0.00062). A correlation between device use and FG was found with a device experience of <2 years (n = 29; r2 = 0.398), whereas no correlation was seen with ≥2 years of device experience (n = 36; r2 = 0.0038). (3) Conclusion: This study found significant relationships between daily device use and FG, wearing comfort and long-term safety (90 months).
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Affiliation(s)
- Milan Urík
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300 Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
- Correspondence: ; Tel.: +420-532-234-440
| | - Soňa Šikolová
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300 Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
| | - Dagmar Hošnová
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300 Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
| | - Vít Kruntorád
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300 Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
| | - Michal Bartoš
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300 Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
| | - Petr Jabandžiev
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
- Department of Pediatrics, University Hospital Brno, 61300 Brno, Czech Republic
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14
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Polonenko MJ, Maddox RK. Optimizing Parameters for Using the Parallel Auditory Brainstem Response to Quickly Estimate Hearing Thresholds. Ear Hear 2022; 43:646-658. [PMID: 34593686 PMCID: PMC8881303 DOI: 10.1097/aud.0000000000001128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Timely assessments are critical to providing early intervention and better hearing and spoken language outcomes for children with hearing loss. To facilitate faster diagnostic hearing assessments in infants, the authors developed the parallel auditory brainstem response (pABR), which presents randomly timed trains of tone pips at five frequencies to each ear simultaneously. The pABR yields high-quality waveforms that are similar to the standard, single-frequency serial ABR but in a fraction of the recording time. While well-documented for standard ABRs, it is yet unknown how presentation rate and level interact to affect responses collected in parallel. Furthermore, the stimuli are yet to be calibrated to perceptual thresholds. Therefore, this study aimed to determine the optimal range of parameters for the pABR and to establish the normative stimulus level correction values for the ABR stimuli. DESIGN Two experiments were completed, each with a group of 20 adults (18-35 years old) with normal-hearing thresholds (≤20 dB HL) from 250 to 8000 Hz. First, pABR electroencephalographic (EEG) responses were recorded for six stimulation rates and two intensities. The changes in component wave V amplitude and latency were analyzed, as well as the time required for all responses to reach a criterion signal-to-noise ratio of 0 dB. Second, behavioral thresholds were measured for pure tones and for the pABR stimuli at each rate to determine the correction factors that relate the stimulus level in dB peSPL to perceptual thresholds in dB nHL. RESULTS The pABR showed some adaptation with increased stimulation rate. A wide range of rates yielded robust responses in under 15 minutes, but 40 Hz was the optimal singular presentation rate. Extending the analysis window to include later components of the response offered further time-saving advantages for the temporally broader responses to low-frequency tone pips. The perceptual thresholds to pABR stimuli changed subtly with rate, giving a relatively similar set of correction factors to convert the level of the pABR stimuli from dB peSPL to dB nHL. CONCLUSIONS The optimal stimulation rate for the pABR is 40 Hz but using multiple rates may prove useful. Perceptual thresholds that subtly change across rate allow for a testing paradigm that easily transitions between rates, which may be useful for quickly estimating thresholds for different configurations of hearing loss. These optimized parameters facilitate expediency and effectiveness of the pABR to estimate hearing thresholds in a clinical setting.
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Affiliation(s)
- Melissa J Polonenko
- Department of Neuroscience, Del Monte Institute for Neuroscience, University of Rochester, NY, USA
- Center for Visual Sciences, University of Rochester, NY, USA
| | - Ross K Maddox
- Department of Neuroscience, Del Monte Institute for Neuroscience, University of Rochester, NY, USA
- Department of Biomedical Engineering, University of Rochester, NY, USA
- Center for Visual Sciences, University of Rochester, NY, USA
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15
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Kondaurova MV, Zheng Q, VanDam M, Kinney K. Vocal Turn-Taking in Families With Children With and Without Hearing Loss. Ear Hear 2022; 43:883-898. [PMID: 34619686 PMCID: PMC8983796 DOI: 10.1097/aud.0000000000001135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Vocal turn-taking is an important predictor of language development in children with and without hearing loss. Most studies have examined vocal turn-taking in mother-child dyads without considering the multitalker context in a child's life. The present study investigates the quantity of vocal turns between deaf and hard-of-hearing children and multiple members of their social environment. DESIGN Participants were 52 families with children who used hearing aids (HA, mean age 26.3 mo) or cochlear implants (CI, mean age 63.2 mo) and 27 families with normal-hearing (NH, mean age 26.6 mo) children. The Language ENvironment Analysis system estimated the number of conversational turns per hour (CTC/hr) between all family members (i.e., adult female, adult male, target child, and other child) during full-day recordings over a period of about 1 year. RESULTS The CTC/hr was lower between the target child and the adult female or adult male in the CI compared with the HA and NH groups. Initially, CTC/hr was higher between the target child and the adult female than between the adult male or the other child. As the child's age increased, turn-taking between the target child and the adult female increased in comparison to that between the target child and the adult male. Over time, turn-taking between the target child and the other child increased and exceeded turn-taking between the target child and the adult caregivers. The increase was observed earlier in families with siblings compared with those without. CONCLUSIONS The quantity of vocal turn-taking depends on the degree of child hearing loss and the relationship between the children and the members of their social environment. Longitudinally, the positive effect of an assistive device on the quantity of turns between the children and their family members was found. The effect was stronger in families with siblings.
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Affiliation(s)
- Maria V Kondaurova
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Qi Zheng
- Department of Bioinformatics & Biostatistics, University of Louisville, Louisville, Kentucky, USA
| | - Mark VanDam
- Department of Speech and Hearing Sciences, Elson S. Floyd College of Medicine, Washington State University, Hearing Oral Program of Excellence (HOPE School) of Spokane, Spokane, Washington, USA
| | - Kaelin Kinney
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, Kentucky, USA
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16
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Shields C, Willis H, Nichani J, Sladen M, Kluk-de Kort K. Listening effort: WHAT is it, HOW is it measured and WHY is it important? Cochlear Implants Int 2021; 23:114-117. [PMID: 34844525 DOI: 10.1080/14670100.2021.1992941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- C Shields
- Department of Paediatric Otolaryngology, Royal Manchester Children's Hospital, Manchester Foundation Trust, Manchester, UK.,Division of Human Communication, Development & Hearing, University of Manchester, Manchester, UK
| | - H Willis
- Independent Stress Management Consultant and CI User, Reading, UK
| | - J Nichani
- Department of Paediatric Otolaryngology, Royal Manchester Children's Hospital, Manchester Foundation Trust, Manchester, UK
| | - M Sladen
- Department of Paediatric Otolaryngology, Royal Manchester Children's Hospital, Manchester Foundation Trust, Manchester, UK
| | - K Kluk-de Kort
- Division of Human Communication, Development & Hearing, University of Manchester, Manchester, UK
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17
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Lazarovska V, Jovanovska M. The role of age on speech development in subjects with cochlear implants. Arch Public Health 2021. [DOI: 10.3889/aph.2021.6001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The cochlear implant has been approved as a method of treating bilateral deep deafness since the 1980s, and since then candidate selection methods have changed several times. Initially, the candidates were only adult patients, and in 1990 the cochlear implant was approved for the first time in children under 2 years of age by the US Food and Drug Administration. In 2000, the same US Administration reduced the limit to one year. The aim of this study was to determine the effect of age at cochlear implantation on speech recognition abilities. Concerning the age groups in which the subjects were assigned to, the best results on the tests were achieved by the group who underwent cochlear implantation at the youngest age. In conclusion, the benefit from cochlear implant in subjects with pre-lingual hearing impairment of the most severe degree has to be stressed and it is much bigger in comparison to individual amplifying hearing aids. If cochlear implant is placed at the youngest age, the results might lead to even 100% of active involvement in the social life of individuals with this kind of impairment.
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18
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Hackenberg B, Büttner M, Große L, Martin E, Cordier D, Matthias C, Läßig AK. [Impact of the COVID-19 pandemic on speech therapy for children with Speech and Language Disorders]. Laryngorhinootologie 2021. [PMID: 34507370 DOI: 10.1055/a-1613-5747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE In December 2019, the COVID-19 pandemic began to spread around the world and caused massive restrictions in our daily life. Many educational facilities and practices delivering speech therapy were temporally closed (so-called lockdown). Children with a speech and language disorder were forced to pause their therapy. The aim of this study was to describe if and how speech therapy was delivered during lockdown and what psychological burden was associated to affected parents. MATERIAL AND METHODS Parents of children with a speech and language disorder were asked about their child´s therapy during lockdown and about their fears and worries associated with it. RESULTS For 17 patients speech therapy was paused during lockdown while 20 patients could continue their therapy. Children speaking a language other than German had a higher risk for having their therapy paused during lockdown (Odds ratio = 5.11, with 95 % confidence interval = 1.09-32.54). Parents whose children did not receive speech therapy during lockdown were more worried about their child's development. CONCLUSIONS There is no common concept on how speech therapy can be delivered safely during lockdown. Possible barriers to healthcare might be more pronounced during the pandemic and parents experience a high psychosocial burden.
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Affiliation(s)
- Berit Hackenberg
- Otorhinolaryngolgy, Head and Neck Surgery, Johannes-Gutenberg-Universität Mainz, Hals-Nasen-Ohrenklinik und Poliklinik, Mainz, Germany
| | | | - Lisa Große
- Otorhinolaryngolgy, Head and Neck Surgery, Johannes-Gutenberg-Universität Mainz, Hals-Nasen-Ohrenklinik und Poliklinik, Mainz, Germany
| | - Evgenia Martin
- Schwerpunkt Kommunikationsstörungen der Hals-Nasen-Ohren-Klinik und Poliklinik - Plastische Operationen, Unimedizin Mainz, Germany
| | - Dahlia Cordier
- Schwerpunkt Kommunikationsstörungen der Hals-Nasen-Ohren-Klinik und Poliklinik - Plastische Operationen, Unimedizin Mainz, Germany
| | - Christoph Matthias
- Otorhinolaryngolgy, Head and Neck Surgery, Johannes-Gutenberg-Universität Mainz, Hals-Nasen-Ohrenklinik und Poliklinik, Mainz, Germany
| | - Anne Katrin Läßig
- Schwerpunkt Kommunikationsstörungen der Hals-Nasen-Ohren-Klinik und Poliklinik - Plastische Operationen, Unimedizin Mainz, Germany
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19
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Glaubitz C, Liebscher T, Hoppe U. Age-related language performance and device use in children with very early bilateral cochlear implantation. Int J Pediatr Otorhinolaryngol 2021; 147:110780. [PMID: 34052573 DOI: 10.1016/j.ijporl.2021.110780] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/21/2021] [Accepted: 05/17/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Paediatric cochlear implantation within the first year of life results in better outcome in auditory and language skills. Beside individual, audiological and social factors, quantity and quality of daily cochlear implant (CI) use also seem to be an influencing factor. The purpose of this study was to evaluate children's early receptive and expressive language performance considering bilingual language development as well as quantity and quality of daily CI use and intraoperative objective measurements. METHODS The retrospective analysis included data from 35 very early bilaterally cochlear-implanted children (age at CI M = 8.4 ± 1.5 months). Language performance was assessed by the German standardised test SETK-2 (age at testing M = 29.4 ± 4.0 months). The CI system-integrated data-logging was analysed with regard to daily CoilOn-time, CoilOff and exposure to classified listening scenes. Intraoperatively measured thresholds of evoked compound action potentials (T-ECAPs) were analysed to ensure CI functionality. RESULTS The cohort showed language performance within the normal range for word comprehension, sentence comprehension and word production, level of sentence production was reduced. Overall, bilingual children performed less well than monolingual children. Intraoperative T-ECAPs were recorded for the total cohort and no anomalies were detected. Children used their CI for about 8.7 ± 1.4 h per day, most of this time spent in a quiet environment (38%). Word production was significantly correlated with the daily duration of CI use (CoilOn-time) and with exposure to the listening environment Speech. No correlation was found between number of daily coil disconnections (CoilOff) and language performance. CONCLUSION Very early bilateral cochlear implantation may result in age-appropriate language skills already at the age of 2 years. Monolingualism seems to a better condition for early language development with CI than bilingualism. Especially for word production, the daily duration of CI use and exposure time in a speech-characterised environment seem to be additional positive factors. Monitoring the data-logs should be one important focus of professionals during the postoperative rehabilitation process to detect potential benefits and risks. These findings should be integrated into rehabilitative therapy and parent counselling.
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20
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Krijger S, Coene M, Govaerts PJ, Dhooge I. Listening Difficulties of Children With Cochlear Implants in Mainstream Secondary Education. Ear Hear 2021; 41:1172-1186. [PMID: 32032224 DOI: 10.1097/aud.0000000000000835] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Previous research has shown that children with cochlear implants (CIs) encounter more communication difficulties than their normal-hearing (NH) peers in kindergarten and elementary schools. Yet, little is known about the potential listening difficulties that children with CIs may experience during secondary education. The aim of this study was to investigate the listening difficulties of children with a CI in mainstream secondary education and to compare these results to the difficulties of their NH peers and the difficulties observed by their teachers. DESIGN The Dutch version of the Listening Inventory for Education Revised (LIFE-R) was administered to 19 children (mean age = 13 years 9 months; SD = 9 months) who received a CI early in life, to their NH classmates (n = 239), and to their teachers (n = 18). All participants were enrolled in mainstream secondary education in Flanders (first to fourth grades). The Listening Inventory for Secondary Education consists of 15 typical listening situations as experienced by students (LIFEstudent) during class activities (LIFEclass) and during social activities at school (LIFEsocial). The teachers completed a separate version of the Listening Inventory for Secondary Education (LIFEteacher) and Screening Instrument for Targeting Educational Risk. RESULTS Participants with CIs reported significantly more listening difficulties than their NH peers. A regression model estimated that 75% of the participants with CIs were at risk of experiencing listening difficulties. The chances of experiencing listening difficulties were significantly higher in participants with CIs for 7 out of 15 listening situations. The 3 listening situations that had the highest chance of resulting in listening difficulties were (1) listening during group work, (2) listening to multimedia, and (3) listening in large-sized classrooms. Results of the teacher's questionnaires (LIFEteacher and Screening Instrument for Targeting Educational Risk) did not show a similar significant difference in listening difficulties between participants with a CI and their NH peers. According to teachers, NH participants even obtained significantly lower scores for staying on task and for participation in class than participants with a CI. CONCLUSIONS Although children with a CI seemingly fit in well in mainstream schools, they still experience significantly more listening difficulties than their NH peers. Low signal to noise ratios (SNRs), distortions of the speech signal (multimedia, reverberation), distance, lack of visual support, and directivity effects of the microphones were identified as difficulties for children with a CI in the classroom. As teachers may not always notice these listening difficulties, a list of practical recommendations was provided in this study, to raise awareness among teachers and to minimize the difficulties.
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Affiliation(s)
- Stefanie Krijger
- Department of Head and Skin, Ghent University, Ghent University Hospital, Gent, Belgium
| | - Martine Coene
- Language and Hearing Center Amsterdam, Free University Amsterdam, Amsterdam, The Netherlands.,The Eargroup, Antwerp, Belgium
| | - Paul J Govaerts
- Language and Hearing Center Amsterdam, Free University Amsterdam, Amsterdam, The Netherlands.,The Eargroup, Antwerp, Belgium
| | - Ingeborg Dhooge
- Department of Head and Skin, Ghent University, Ghent University Hospital, Gent, Belgium
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21
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Abstract
Objectives: This longitudinal study followed the language development of children who received the combination of early (5 to 18 months) and simultaneous bilateral cochlear implants (CIs) throughout the first 6 years after implantation. It examined the trajectories of their language development and identified factors associated with language outcomes. Design: Participants were 21 Norwegian children who received bilateral CIs between the ages of 5 and 18 mo and 21 children with normal hearing (NH) who were matched to the children with CIs on age, sex, and maternal education. The language skills of these two groups were compared at 10 time points (3, 6, 9, 12, 18, 24, 36, 48, 60, and 72 months after implantation) using parent reports and standardized measures of general language skills, vocabulary, and grammar. In addition, assessments were made of the effects of age at CI activation, speech recognition abilities, and mothers’ education on language outcomes 6 years after implantation. Results: During the first 4 years after implantation, the gap in general expressive and receptive language abilities between children with CIs and children with NH gradually closed. While at the initial five to six assessments (3 to 36 months after implantation), significant differences between children with CIs and children with NH were observed; at 4 years after implantation, there were no longer any significant group differences in general language skills and most children with CIs achieved scores within 1 SD of the tests’ normative means. From 2 to 3 years after implantation onward, expressive vocabulary and receptive grammar skills of children with CIs were similar to those of the reference group. However, from 4 years after implantation until the end of the observation period, 6 years after implantation, expressive grammar skills of children with CIs were lower than those of children with NH. In addition, a gap in receptive vocabulary appeared and grew increasingly larger from 4 to 6 years postimplantation. At the final assessment, the children with CIs had an average receptive vocabulary score around 1 SD below the normative mean. Regression analysis indicated that the children’s language outcomes at 6 years after implantation were related to their speech recognition skills, age at CI activation, and maternal education. Conclusions: In the first 4 years after implantation, the language performance of children with CIs became increasingly similar to that of their NH peers. However, between 4 and 6 years after implantation, there were indications of challenges with certain aspects of language, specifically receptive vocabulary and expressive grammar. Because these challenges first appeared after the 4-year assessment, the findings underline the importance of long-term language intervention to increase the chances of a continued language development comparable to that of NH peers. They also indicate that there is a need for comprehensive longitudinal studies of the language development of children with CIs beyond 4 years after implantation.
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22
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Naik AN, Varadarajan VV, Malhotra PS. Early pediatric Cochlear implantation: An update. Laryngoscope Investig Otolaryngol 2021. [PMID: 34195373 DOI: 10.1002/lio2.574/format/pdf] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
The criteria and candidacy for pediatric cochlear implantation (CI) has significantly transformed over the past few decades and continues to evolve with technological advancements, and recognition of benefit in more diverse populations. Prolonged auditory deprivation among patients with profound sensorineural hearing loss has been shown to cause widespread degeneration in the central auditory system. Thus, there is increasing evidence advocating for earlier implantation within a critical neuroplastic window. However, there is a lack of consensus on this optimal age of implantation. Historically, there were concerns regarding surgical feasibility and safety, anesthesia risk, and logistical considerations in very young infants <12 months. Recent literature has investigated surgical safety and anesthesia risk as well speech and language outcomes with early implantation, resulting in the long-awaited reduction in approved age by the FDA (<9 months for certain devices). This article reviews logistical considerations, surgical safety, anesthesia risk, and language developmental outcomes associated with early CI (<12 months).
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Affiliation(s)
- Akash N Naik
- Department of Otolaryngology - Head and Neck Surgery The Ohio State University Columbus Ohio USA
| | - Varun V Varadarajan
- Department of Otolaryngology - Head and Neck Surgery The Ohio State University Columbus Ohio USA
| | - Prashant S Malhotra
- Division of Pediatric Otolaryngology Nationwide Children's Hospital Columbus Ohio USA
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23
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Naik AN, Varadarajan VV, Malhotra PS. Early pediatric Cochlear implantation: An update. Laryngoscope Investig Otolaryngol 2021; 6:512-521. [PMID: 34195373 PMCID: PMC8223461 DOI: 10.1002/lio2.574] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/27/2021] [Accepted: 04/11/2021] [Indexed: 11/17/2022] Open
Abstract
The criteria and candidacy for pediatric cochlear implantation (CI) has significantly transformed over the past few decades and continues to evolve with technological advancements, and recognition of benefit in more diverse populations. Prolonged auditory deprivation among patients with profound sensorineural hearing loss has been shown to cause widespread degeneration in the central auditory system. Thus, there is increasing evidence advocating for earlier implantation within a critical neuroplastic window. However, there is a lack of consensus on this optimal age of implantation. Historically, there were concerns regarding surgical feasibility and safety, anesthesia risk, and logistical considerations in very young infants <12 months. Recent literature has investigated surgical safety and anesthesia risk as well speech and language outcomes with early implantation, resulting in the long-awaited reduction in approved age by the FDA (<9 months for certain devices). This article reviews logistical considerations, surgical safety, anesthesia risk, and language developmental outcomes associated with early CI (<12 months).
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Affiliation(s)
- Akash N. Naik
- Department of Otolaryngology – Head and Neck SurgeryThe Ohio State UniversityColumbusOhioUSA
| | - Varun V. Varadarajan
- Department of Otolaryngology – Head and Neck SurgeryThe Ohio State UniversityColumbusOhioUSA
| | - Prashant S. Malhotra
- Division of Pediatric OtolaryngologyNationwide Children's HospitalColumbusOhioUSA
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24
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Matusiak M, Oziębło D, Obrycka A, Ołdak M, Kaczmarek L, Skarżyński P, Skarżyński H. Functional Polymorphism of MMP9 and BDNF as Potential Biomarker of Auditory Neuroplasticity in Prelingual Deafness Treatment With Cochlear Implantation-A Retrospective Cohort Analysis. Trends Hear 2021; 25:23312165211002140. [PMID: 33787399 PMCID: PMC8020743 DOI: 10.1177/23312165211002140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Genetic biomarkers of neuroplasticity in deaf children treated with cochlear implantation (CI) might facilitate their clinical management, especially giving them better chances of developing proficient spoken language. We investigated whether carrying certain variants of the genes encoding matrix metalloproteinase MMP9 and neurotrophin brain-derived neurotrophic factor (BDNF), involved in synaptic plasticity, can be taken as prognostic markers of how well auditory skills might be acquired. Association analysis of functional MMP9 rs3918242 and BDNF rs6265 variants and the child’s auditory development measured at CI activation and 1, 5, 9, 14, and 24 months post CI activation with LittlEARS Questionnaire (LEAQ) was conducted in a group of 100 children diagnosed with DFNB1-related deafness, unilaterally implanted before the age of 2 years. Statistical analysis in the subgroup implanted after 1 year of life (n = 53) showed significant association between MMP9 rs3918242 and LEAQ scores at 1 month (p = .01), at 5 months (p = .01), at 9 months (p = .01), and at 24 months (p = .01) after CI activation. No significant associations in the subgroup implanted before 1 year of life were observed. No significant associations between the BDNF rs6265 and LEAQ score were found. Multiple regression analysis (R2 = .73) in the subgroup implanted after 1 year of life revealed that MMP9 rs3918242 was a significant predictor of treatment outcome. In conclusion, C/C rs3918242 MMP9 predisposes their deaf carriers to better CI outcomes, especially when implanted after the first birthday, than carriers of C/T rs3918242MMP9.
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Affiliation(s)
- Monika Matusiak
- Otorhinolaryngosurgery Clinic, Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,World Hearing Centre, Nadarzyn, Poland
| | - Dominika Oziębło
- World Hearing Centre, Nadarzyn, Poland.,Department of Genetics, Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,Postgraduate School of Molecular Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Anita Obrycka
- World Hearing Centre, Nadarzyn, Poland.,Department of Implants and Auditory Perception, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Monika Ołdak
- World Hearing Centre, Nadarzyn, Poland.,Department of Genetics, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Leszek Kaczmarek
- BRAINCITY, Nencki Institute of Experimental Biology, Warsaw, Poland
| | - Piotr Skarżyński
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,Heart Failure and Cardiac Rehabilitation Department, 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.,Institute of Sensory Organs, Kajetany, Poland
| | - Henryk Skarżyński
- Otorhinolaryngosurgery Clinic, Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,World Hearing Centre, Nadarzyn, Poland
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25
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Tohidast SA, Mansuri B, Bagheri R, Azimi H. Provision of speech-language pathology services for the treatment of speech and language disorders in children during the COVID-19 pandemic: Problems, concerns, and solutions. Int J Pediatr Otorhinolaryngol 2020; 138:110262. [PMID: 32705994 PMCID: PMC7361043 DOI: 10.1016/j.ijporl.2020.110262] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 12/24/2022]
Abstract
Recently, a novel virus has spread worldwide causing the disease called COVID-19. In addition to putting people's lives at risk and causing mortality, various problems have occurred due to the negative effects of the COVID-19 pandemic. Quarantine, social distancing, and the obligation to use protective tools have led to sometimes long term closing of various jobs and services, including rehabilitation services. For instance, the disease has interrupted the provision of Speech-Language Pathology (SLP) services to children due to the need for face-to-face communication between Speech and Language Pathologists (SLPs) and children during the evaluation and treatment processes. Therefore, here, we described the quality of providing SLP services during the COVID-19 pandemic and the negative effects of the disease on the provision of SLP services. In addition, we made an attempt to explain concerns and problems raised by the families, the importance of providing SLP services during the critical period of speech and language development, telepractice services, the roles of speech-language-hearing related scientific associations, and the roles of SLPs during the outbreak of COVID-19.
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Affiliation(s)
- Seyed Abolfazl Tohidast
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | - Banafshe Mansuri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | - Rasool Bagheri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | - Hadi Azimi
- English Language Teaching Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Lee Y. Phonological Awareness Skills in Children With Early and Late Cochlear Implantation: Effects of Task and Phonological Unit. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:2930-2939. [PMID: 32812849 DOI: 10.1044/2020_jslhr-19-00340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose Phonological awareness (PA) skills are critical for spoken language acquisition and literacy. PA manifests in various skills that can be identified based on task performance and speech sound unit size. This study compared the PA skills of children with early cochlear implantation (E-CI), children with late cochlear implantation (L-CI), and children with typical hearing (TH) in relation to task and phonological unit. It also attempted to identify the significant predictors of PA skills in each CI and TH group. Method Twenty children with E-CI, 20 children with L-CI, and 20 children with TH participated in this study. PA skills were assessed using elision, blending, and segmenting tasks at both the syllabic and phonemic levels. Results The E-CI and L-CI groups performed significantly less well than the TH group on the elision and blending tasks at the syllabic level. However, the E-CI group performed at a similar level as the TH group in the segmenting tasks at both the syllabic and phonemic levels. The regression analysis identified age at implantation and receptive vocabulary scores as significant predictors of PA skills in children with CIs. Conclusions Although all the children with CIs had age-appropriate receptive vocabulary skills, the PA skills of both the E-CI and L-CI groups tended to lag behind those of the TH group in the elision and blending tasks at the syllabic level. Age at implantation and receptive vocabulary skills affected the development of PA skills in children with CIs.
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Affiliation(s)
- Youngmee Lee
- Department of Communication Disorders, Ewha Womans University, Seoul, South Korea
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Arjunan A, Bellerose H, Torres R, Ben-Shachar R, Hoffman JD, Angle B, Slotnick RN, Simpson BN, Lewis AM, Magoulas PL, Bontempo K, Schulze J, Tarpinian J, Bucher JA, Dineen R, Goetsch A, Lazarin GA, Johansen Taber K. Evaluation and classification of severity for 176 genes on an expanded carrier screening panel. Prenat Diagn 2020; 40:1246-1257. [PMID: 32474937 PMCID: PMC7540025 DOI: 10.1002/pd.5762] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/20/2020] [Accepted: 05/22/2020] [Indexed: 02/06/2023]
Abstract
Background Disease severity is important when considering genes for inclusion on reproductive expanded carrier screening (ECS) panels. We applied a validated and previously published algorithm that classifies diseases into four severity categories (mild, moderate, severe, and profound) to 176 genes screened by ECS. Disease traits defining severity categories in the algorithm were then mapped to four severity‐related ECS panel design criteria cited by the American College of Obstetricians and Gynecologists (ACOG). Methods Eight genetic counselors (GCs) and four medical geneticists (MDs) applied the severity algorithm to subsets of 176 genes. MDs and GCs then determined by group consensus how each of these disease traits mapped to ACOG severity criteria, enabling determination of the number of ACOG severity criteria met by each gene. Results Upon consensus GC and MD application of the severity algorithm, 68 (39%) genes were classified as profound, 71 (40%) as severe, 36 (20%) as moderate, and one (1%) as mild. After mapping of disease traits to ACOG severity criteria, 170 out of 176 genes (96.6%) were found to meet at least one of the four criteria, 129 genes (73.3%) met at least two, 73 genes (41.5%) met at least three, and 17 genes (9.7%) met all four. Conclusion This study classified the severity of a large set of Mendelian genes by collaborative clinical expert application of a trait‐based algorithm. Further, it operationalized difficult to interpret ACOG severity criteria via mapping of disease traits, thereby promoting consistency of ACOG criteria interpretation.
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Affiliation(s)
- Aishwarya Arjunan
- Division of Medical Affairs, Myriad Women's Health, South San Francisco, CA, USA
| | - Holly Bellerose
- Division of Medical Affairs, Myriad Women's Health, South San Francisco, CA, USA
| | - Raul Torres
- Division of Medical Affairs, Myriad Women's Health, South San Francisco, CA, USA
| | - Rotem Ben-Shachar
- Division of Medical Affairs, Myriad Women's Health, South San Francisco, CA, USA
| | - Jodi D Hoffman
- Department of Pediatric Genetics, Boston University School of Medicine, Boston, MA, USA
| | - Brad Angle
- Division of Genetics, Advocate Children's Hospital, Park Ridge, IL, USA
| | | | - Brittany N Simpson
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Andrea M Lewis
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.,Department of Molecular and Human Genetics, Texas Children's Hospital, Houston, TX, USA
| | - Pilar L Magoulas
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.,Department of Molecular and Human Genetics, Texas Children's Hospital, Houston, TX, USA
| | - Kelly Bontempo
- Division of Genetics, Advocate Children's Hospital, Park Ridge, IL, USA
| | - Jeanine Schulze
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jennifer Tarpinian
- Individualized Medical Genetics Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jessica A Bucher
- Division of Genetics, Advocate Children's Hospital, Park Ridge, IL, USA
| | - Richard Dineen
- Department of Clinical Genetics and Genomics, Rush University Medical Center, Chicago, IL, USA
| | - Allison Goetsch
- Division of Genetics, Birth Defects & Metabolism, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Gabriel A Lazarin
- Division of Medical Affairs, Myriad Women's Health, South San Francisco, CA, USA
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Yang Y, Chen M, Zheng J, Hao J, Liu B, Liu W, Li B, Shao J, Liu H, Ni X, Zhang J. Clinical evaluation of cochlear implantation in children younger than 12 months of age. Pediatr Investig 2020; 4:99-103. [PMID: 32851352 PMCID: PMC7331375 DOI: 10.1002/ped4.12202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 02/02/2020] [Indexed: 11/11/2022] Open
Abstract
IMPORTANCE Cochlear implantation (CI) is an effective therapy for patients with severe to profound sensorineural hearing loss. It remains controversial whether children younger than 12 months of age should undergo CI. OBJECTIVE To evaluate the safety and effectiveness of CI in children younger than 12 months of age. METHODS We performed a retrospective study of clinical data of pediatric patients younger than 12 months of age who underwent CI and were followed up for 1 to 2 years. Patients' developmental levels were evaluated by the Gesell score before CI. Intraoperative and postoperative complications were recorded to evaluate the safety of CI. Auditory and speech abilities were scored by the LittlEARS® auditory questionnaire (LEAQ), categories of auditory performance (CAP), speech intelligibility rating (SIR), infant-toddler meaningful auditory integration scale (IT-MAIS), and meaningful use of speech scale (MUSS) at 1, 2, 3, 6, 9, and 12 months after CI. The associations between clinical characteristics before CI and postoperative scores at 1 year after CI were analyzed by the linear mixed-effects model. RESULTS Eighty-nine children (47 boys and 42 girls) were included in this study (mean age at CI, 9.2 ± 1.6 months). Sixteen patients were diagnosed with cochlear malformation and 16 underwent bilateral CI. No severe complications occurred in any patients. The mean developmental quotient of the Gesell score was 78.00 ± 10.03. The median LEAQ scores were 0, 5, 10, 16, 22, 26 and 30 before and at 1, 2, 3, 6, 9, and 12 months after CI, respectively. These findings implied that the LEAQ score greatly improved in the first year after CI. The overall CAP, SIR, IT-MAIS, and MUSS scores also increased with increasing duration after CI. No significant associations were detected between clinical characteristics (age, sex, implant number, pre-CI Gesell score, and inner ear malformation) and LEAQ outcomes at 12 months after CI. INTERPRETATION With increasing duration after CI, auditory and speech behavior dramatically improve in young children. Our findings indicate that CI is feasible for children younger than 12 months of age.
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Affiliation(s)
- Yang Yang
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Min Chen
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Jun Zheng
- Beijing Tongren HospitalCapital Medical UniversityBeijingChina
| | - Jinsheng Hao
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Bing Liu
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Wei Liu
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Bei Li
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Jianbo Shao
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Haihong Liu
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Xin Ni
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
| | - Jie Zhang
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology‐Head and Neck SurgeryBeijingChina
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Khoramian S, Soleymani Z, Keramati N, Motasaddi Zarandy M. Effect of cochlear implantation on language development and assessment of the quality of studies in this field: A systematic review. Med J Islam Repub Iran 2020; 33:107. [PMID: 31934567 PMCID: PMC6946925 DOI: 10.34171/mjiri.33.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Indexed: 11/05/2022] Open
Abstract
Background: Cochlear implantation (CI) is an achievement that facilitates the acquisition of language skills in deaf children throughout the world. The use of this technology has a positive effect on all components of language acquisition (syntax, semantic, pragmatic, etc.). However, this positive impact is influenced by various factors. Understanding the strengths and weaknesses of studies on the development of language abilities can help improve these studies. Consequently, in the future, it will lead to the improvement of language rehabilitation in these children. Limited studies on children with CI in have been done so far. This article summarized the outcomes of scientific articles on the clinical efficacy of CI on Persian speaking children. This study also provided a clear picture of these studies by examining the quality of their methodologies and tools. Methods: Articles indexed in Google Scholar, Web of Science, Medline, Scopus and Iranian databases (Danesh Gostar, Magiran, and SID) were searched using keywords "language," "Cochlear implant", "Persian/ Farsi" in English and Persian languages with "and/or". Original articles investigated on children younger than 13 years old with hearing impairment and CI were included. Results: Five hundred and twenty-three articles were found based on the keywords. Among all of these, 485 were excluded due to the title and the abstract; we selected 38, of which 24 were repeated. Finally, 14 articles remained. We reviewed the articles based on the preferred reporting items for systematic review and meta-analysis (PRISMA) and checklist and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Conclusion: Similar to international studies, Persian speaking children with CI have slower language development than their peers with normal hearing, but they are better than their peers who use hearing aids. The results of reviewing on quality of the articles showed that the studies could not meet reasonable quality because of the lack of a standard test in different aspects of Persian language and the absence of patients’ databanks. These results also can be used by other nationalities that recently have started surveys on children with CIs.
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Affiliation(s)
- Soodeh Khoramian
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Soleymani
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Keramati
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Motasaddi Zarandy
- Department of Cochlear Implant, Otorhinolaryngology Research Center, Amir Aalam Hospital, Tehran, Iran
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Scarabello EM, Lamônica DAC, Morettin-Zupelari M, Tanamati LF, Campos PD, Alvarenga KDF, Moret ALM. Language evaluation in children with pre-lingual hearing loss and cochlear implant. Braz J Otorhinolaryngol 2020; 86:91-98. [PMID: 30527397 PMCID: PMC9422593 DOI: 10.1016/j.bjorl.2018.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 09/25/2018] [Accepted: 10/21/2018] [Indexed: 01/19/2023] Open
Abstract
Introduction The cochlear implant is an effective device for children with severe and/or profound prelingual hearing loss, since it provides considerable improvement in oral language acquisition through the auditory pathway. The use of a cochlear implant contributes to the development of auditory perception, favoring the acquisition of the linguistic processes related to communication skills, which might have a positive effect on other areas of development. Objective The aim of this study was to verify the performance of children using cochlear implants for expressive and receptive oral language. Methods This was a prospective cross-sectional study that used the following tests: Child language test in the phonology, vocabulary, fluency and pragmatics areas, and the Peabody picture vocabulary test. Thirty children participated in this study, of both genders, aged between 36 and 72 months, with severe and/or profound bilateral sensorineural hearing loss, without other impairments and users of unilateral cochlear implant with full electrode insertion for a minimum of 12 months. Results The longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language. Even though when compared to the normative language acquisition process, the results showed that these children had patterns of linguistic skills that are below their chronological age; the results indicate that these children are developing expressive and receptive oral language skills, and this is the outcome that should be taken into account in this study. Conclusion The longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language skills, but not in all the studied semantic categories.
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Duchesne L, Marschark M. Effects of Age at Cochlear Implantation on Vocabulary and Grammar: A Review of the Evidence. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:1673-1691. [PMID: 31513745 DOI: 10.1044/2019_ajslp-18-0161] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The increasing prevalence of pediatric cochlear implantation over the past 25 years has left little doubt that resulting improvements in hearing offer significant benefits to language development for many deaf children. Furthermore, given the documented importance of access to language from birth, there has been strong support for providing congenitally deaf children with implants as early as possible. Earliest implantation, in many ways, has become the "gold standard" in pediatric cochlear implantation, on the assumption that it is the key to language development similar to that of hearing children. Empirical evidence to support this assumption, however, appears more equivocal than generally is believed. This article reviews recent research aimed at assessing the impact of age at implantation on vocabulary and grammatical development among young implant users. Method Articles published between 2003 and 2018 that included age at implantation as a variable of interest and in which it was subjected to statistical analysis were considered. Effect sizes were calculated whenever possible; we conducted a multivariate meta-analysis to compare outcomes in different language domains. Results Taken together, findings from 49 studies suggest that age at implantation is just one of a host of variables that influence vocabulary and grammatical development, its impact varying with several factors including whether age at implantation is treated as a dichotomous or continuous variable. Results from a meta-analysis showed significant differences across language domains. Conclusion The pattern of results obtained indicates the importance of considering various child, family, and environmental characteristics in future research aimed at determining how early "early implantation" needs to be and the extent to which age at implantation, duration of implant use, and other factors influence language and language-related outcomes. Supplemental Material https://doi.org/10.23641/asha.9789041.
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Affiliation(s)
- Louise Duchesne
- Département d'Orthophonie, Université du Québec à Trois-Rivières, Canada
| | - Marc Marschark
- National Technical Institute for the Deaf, Rochester Institute of Technology, NY
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Bhamjee A, Roux TL, Schlemmer K, Perold J, Cass N, Schroeder K, Schlesinger D, Ceronio D, Vinck B. Parent-perceived challenges related to the pediatric cochlear implantation process and support services received in South Africa. Int J Pediatr Otorhinolaryngol 2019; 126:109635. [PMID: 31421357 DOI: 10.1016/j.ijporl.2019.109635] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/31/2019] [Accepted: 08/07/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine and describe parent-perceived challenges related to the pediatric cochlear implantation process and support services received. METHOD A multicenter survey study across six cochlear implant (CI) programs in South Africa (SA) was conducted. The study sample included 82 parents of pediatric (≤18 years) CI recipients with at least 12 months CI experience. A self-administered questionnaire was developed for the purpose of this study, exploring parental challenges regarding the CI process, education of their implanted children and the support services received. RESULTS The financial implications of cochlear implantation, including CI device maintenance, were identified by parents as the most prominent challenge. Financing issues were the highest scoring reason that attributed to the delay between diagnosis of hearing loss and cochlear implantation, as well as the greatest barrier to bilateral implantation. Parent-perceived educational challenges included finding adequate educational settings specific to the individual needs of their child and a shortage of trained teachers equipped to support children with CIs. The presence of one/more additional developmental conditions and grade repetition were associated with more pronounced parent-perceived educational challenges. Parents considered speech-language therapy as the most critical support service for their implanted children to achieve optimal outcomes, while parent guidance was indicated to be the most critical support service required for parents of pediatric CI recipients. CONCLUSION A greater understanding of parent-perceived challenges will guide CI professionals to promote optimal outcomes, evidence-based service delivery and on-going support to pediatric CI recipients and their families. Study results imply a call for action regarding financial and educational support for pediatric CI recipients in SA.
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Affiliation(s)
- Aaqilah Bhamjee
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Talita le Roux
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa.
| | - Kurt Schlemmer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Kwazulu Natal, Durban, South Africa; Durban Cochlear Implant Program, Durban, South Africa
| | - Jenny Perold
- Tygerberg Hospital-Stellenbosch University Cochlear Implant Unit, Cape Town, South Africa
| | - Nicolize Cass
- Pretoria Cochlear Implant Unit, Pretoria, South Africa
| | - Kelly Schroeder
- Port Elizabeth Cochlear Implant Unit, Port Elizabeth, South Africa
| | - Dani Schlesinger
- Chris Hani Baragwanath Academic Hospital Cochlear Implant Program, Soweto, South Africa
| | - Deon Ceronio
- Bloemfontein Cochlear Implant Program, Bloemfontein, South Africa
| | - Bart Vinck
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa; Speech-Language Audiology Department, Ghent University, Gent, Belgium
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Long-term Outcomes in Down Syndrome Children After Cochlear Implantation: Particular Issues and Considerations. Otol Neurotol 2019; 40:1278-1286. [PMID: 31634275 DOI: 10.1097/mao.0000000000002410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to analyze the long-term outcomes after cochlear implantation in deaf children with Down syndrome (DS) regarding age at the first implantation and refer the results to preoperative radiological findings as well as postoperative auditory and speech performance. Additionally, the influence of the age at implantation and duration of CI use on postoperative hearing and language skills were closely analyzed in children with DS. STUDY DESIGN Retrospective analysis. SETTING Referral center (Cochlear Implant Center). MATERIALS AND METHODS Nine children with Down syndrome were compared with 220 pediatric patients without additional mental disorders or genetic mutations. Patients were divided into four categories depending on the age of the first implantation: CAT1 (0-3 yr), CAT2 (4-5 yr), CAT3 (6-7 yr), and CAT4 (8-17 yr). The auditory performance was assessed with the meaningful auditory integration scales (MAIS) and categories of auditory performance (CAP) scales. The speech and language development were further evaluated with meaningful use of speech scale (MUSS) and speech intelligibility rating (SIR). The postoperative speech skills were analyzed and compared between the study group and the reference group by using nonparametric statistical tests. Anatomic abnormalities of the inner ear were examined using magnetic resonance imaging (MRI) and high-resolution computed tomography of the temporal bones (HRCT). RESULTS The mean follow-up time was 14.9 years (range, 13.1-18.3 yr). Patients with DS received a multichannel implant at a mean age of 75.3 months (SD 27.9; ranging from 21 to 127 mo) and 220 non-syndromic children from reference group at a mean age of 51.4 months (SD 34.2; ranging from 9 to 167 mo). The intraoperative neural response was present in all cases. The auditory and speech performance improved in each DS child. The postoperative mean CAP and SIR scores were 4.4 (SD 0.8) and 3.2 (SD 0.6), respectively. The average of scores in MUSS and MAIS/IT-MAIS scales was 59.8% (SD 0.1) and 76.9% (SD 0.1), respectively. Gathered data indicates that children with DS implanted with CI at a younger age (<6 years of age) benefited from the CI more than children implanted later in life, similarly in a control group. There were additional anomalies of the temporal bone, external, middle, or inner ear observed in 90% of DS children, basing on MRI or HRCT. CONCLUSIONS The early cochlear implantation in children with DS is a similarly useful method in treating severe to profound sensorineural hearing loss (SNHL) as in non-syndromic patients, although the development of speech skills present differently. Due to a higher prevalence of ear and temporal bone malformations, detailed diagnostic imaging should be taken into account before the CI qualification. Better postoperative outcomes may be achieved through comprehensive care from parents/guardians and speech therapists thanks to intensive and systematic rehabilitation.
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Simon F, Roman S, Truy E, Barone P, Belmin J, Blanchet C, Borel S, Charpiot A, Coez A, Deguine O, Farinetti A, Godey B, Lazard D, Marx M, Mosnier I, Nguyen Y, Teissier N, Virole B, Lescanne E, Loundon N. Guidelines (short version) of the French Society of Otorhinolaryngology (SFORL) on pediatric cochlear implant indications. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:385-391. [DOI: 10.1016/j.anorl.2019.05.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ghiselli S, Gheller F, Trevisi P, Favaro E, Martini A, Ermani M. Restoration of auditory network after cochlear implant in prelingual deafness: a P300 study using LORETA. ACTA ACUST UNITED AC 2019; 40:64-71. [PMID: 31570903 PMCID: PMC7147536 DOI: 10.14639/0392-100x-2316] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 11/24/2018] [Indexed: 11/23/2022]
Abstract
The concept of auditory restoration after cochlear implant (CI) in prelingual deafness is well described by a synaptic network model, whose development depends on sensory experience. The aim of this work was to study the associative networks activated by the CI in a population of prelingually deaf patients. In particular, the impact of age at time of first CI fitting and duration of CI use was evaluated. Twenty patients were tested and divided into three groups: early implanted and lengthy CI use (group A); late implanted and lengthy CI use (group B); late implanted and short CI use (group C). Each patient group was compared with a normal hearing age matched control group. All subjects underwent to auditory event-related potentials (ERPs) registration. ERP latencies and their cortical sources were investigated. Cortical source analysis was performed using LORETA (Low Resolution Electromagnetic Tomography) software. P300 latencies were significantly longer in patients than in controls. The amount of cortical activation was found to be significantly directly correlated with duration of implant use and significantly correlated inversely with age at implant. When comparing patients and controls, comparable cortical activation was only found in A patient group, and to a lesser extent in group B, while significantly lower activation was found in patient group C in the frontal and cingulate areas. CI adds a sensory modality in deafness patients, i.e. the auditory one. This involves areas implicated in sensory and cognitive functions, and needs some time to form. The duration of CI use is crucial: our results demonstrate the importance of long term use of the device in addition to an early time of implant.
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Affiliation(s)
- Sara Ghiselli
- Institute for Maternal and Child Health- IRCSS Burlo Garofolo, Trieste, Italy
| | - Flavia Gheller
- ENT Clinic, Department of Neuroscience, Padova University Hospital, Padova, Italy
| | - Patrizia Trevisi
- ENT Clinic, Department of Neuroscience, Padova University Hospital, Padova, Italy
| | - Emanuele Favaro
- Neurological Clinic, Department of Neuroscience, Padova University Hospital, Padova, Italy
| | - Alessandro Martini
- ENT Clinic, Department of Neuroscience, Padova University Hospital, Padova, Italy
| | - Mario Ermani
- Neurological Clinic, Department of Neuroscience, Padova University Hospital, Padova, Italy
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Receptive and productive speech and language abilities in hearing-impaired children with German as a second language. Int J Pediatr Otorhinolaryngol 2019; 120:100-107. [PMID: 30772612 DOI: 10.1016/j.ijporl.2019.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 02/02/2019] [Accepted: 02/02/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Many studies examining early bilingualism in migrant populations focus on the development of the first language. As language acquisition is closely related to the hearing development, there is a critical need to investigate language development in hearing-impaired children being raised bilingually who were fitted with cochlear implants and/or hearing aids. Therefore, this research project aimed to study the linguistic development of hearing-impaired children being raised with German as a second language who were provided with hearing aids or cochlear implants. Further, the language development of these children is compared with that of hearing-impaired children being raised in a monolingual environment and with normal-hearing children being raised bilingually. METHODS In this prospective study, we analyzed data from 95 typically developing children with hearing loss (43 bilingual and 52 monolingual) aged 3;0 to 10;11 (years; months) on four language measures in German: receptive vocabulary, productive vocabulary, receptive grammar, productive grammar (sentence repetition). Additionally, 30 bilingual children with normal hearing were included in this study. RESULTS 44 children were provided with hearing aids in both ears; 34 used cochlear implants bilaterally and 17 were fitted bimodally. Statistical analysis showed that bilingual hearing-impaired children scored significantly poorer than monolingual hearing-impaired children. CONCLUSION Hearing-impaired children being raised bilingually should have speech and language examinations on a regular basis. An examination of both languages would be desirable in order to be able to fully assess speech and language acquisition.
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Bilateral duplication of the internal auditory canals and bilateral cochlear implant outcomes and review. Int J Pediatr Otorhinolaryngol 2019; 119:41-46. [PMID: 30665175 DOI: 10.1016/j.ijporl.2019.01.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Bilateral duplication of the internal auditory canal (IAC) is rare and is associated with profound sensorineural hearing loss. The present study aims to review our experience with bilateral cochlear implantation (CI) in children with a duplication of the IAC and to review the literature. METHODS The Sydney Cochlear Implant Centre database was searched for children with duplication of the internal auditory canal. Data was collected regarding clinical history, MRI and CT findings, auditory brainstem responses (ABR), tympanometry and otoacoustic emissions (OAE), visually reinforced orientation audiometry, auditory brainstem response, electrocochleography (ECochG), transtympanic electrical auditory brainstem response (ABR), aided cortical evoked potentials (CAEP) and intraoperative neural response telemetry (NRT) and CI evoked electrical auditory brainstem testing. RESULTS two children with bilateral duplication of the IAC were identified who successfully underwent bilateral cochlear implantation. Audiological development was monitored for 2 and 3 years respectively, both children could spontaneously verbalise and displayed Categories of Auditory Performance (CAP) score of 5 and 6 respectively. CONCLUSION Children with duplication of the IAC, with accompanying cochlear nerve dysplasia (CND) can benefit from CI surgery, and verbal receptive and expressive language is possible.
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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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Polonenko MJ, Maddox RK. The Parallel Auditory Brainstem Response. Trends Hear 2019; 23:2331216519871395. [PMID: 31516096 PMCID: PMC6852359 DOI: 10.1177/2331216519871395] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 11/21/2022] Open
Abstract
The frequency-specific tone-evoked auditory brainstem response (ABR) is an indispensable tool in both the audiology clinic and research laboratory. Most frequently, the toneburst ABR is used to estimate hearing thresholds in infants, toddlers, and other patients for whom behavioral testing is not feasible. Therefore, results of the ABR exam form the basis for decisions regarding interventions and hearing habilitation with implications extending far into the child's future. Currently, responses are elicited by periodic sequences of toneburst stimuli presented serially to one ear at a time, which take a long time to measure multiple frequencies and intensities, and provide incomplete information if the infant wakes up early. Here, we describe a new method, the parallel ABR (pABR), which uses randomly timed toneburst stimuli to simultaneously acquire ABR waveforms to five frequencies in both ears. Here, we describe the pABR and quantify its effectiveness in addressing the greatest drawback of current methods: test duration. We show that in adults with normal hearing the pABR yields high-quality waveforms over a range of intensities, with similar morphology to the standard ABR in a fraction of the recording time. Furthermore, longer latencies and smaller amplitudes for low frequencies at a high intensity evoked by the pABR versus serial ABR suggest that responses may have better place specificity due to the masking provided by the other simultaneous toneburst sequences. Thus, the pABR has substantial potential for facilitating faster accumulation of more diagnostic information that is important for timely identification and treatment of hearing loss.
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Affiliation(s)
- Melissa J. Polonenko
- Department of Biomedical Engineering, University of Rochester, NY, USA
- Department of Neuroscience, Del Monte Institute for Neuroscience, University of Rochester, NY, USA
| | - Ross K. Maddox
- Department of Biomedical Engineering, University of Rochester, NY, USA
- Department of Neuroscience, Del Monte Institute for Neuroscience, University of Rochester, NY, USA
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Jung J, Ertmer DJ. Grammatical Abilities in Young Cochlear Implant Recipients and Children With Normal Hearing Matched by Vocabulary Size. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:751-764. [PMID: 29625430 PMCID: PMC6105123 DOI: 10.1044/2018_ajslp-16-0164] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 05/30/2017] [Accepted: 12/17/2017] [Indexed: 05/29/2023]
Abstract
PURPOSE This study sought to expand understanding of the impact of cochlear implantation on grammatical acquisition by comparing young children who have vocabularies of comparable size. Two research questions were investigated: (a) Do young cochlear implant (CI) recipients have grammatical skills comparable to those of children with normal hearing (NH) matched by spoken vocabulary size? (b) Do these groups show associations between vocabulary size and grammatical measures? METHOD The participants included 13 CI recipients at 24 months postactivation (chronological ages = 33-60 months; M = 44.62) and 13 children with NH between 27 and 30 months old (M = 20.69). The 2 groups were matched by their vocabulary size. Four grammatical outcomes were analyzed from the MacArthur Communicative Development Inventory (Fenson, Marchman, Thal, Dale, & Reznick, 2007) and 20-min language samples: (a) grammatical complexity, (b) mean length of utterances, (c) tense marker total, and (d) productivity scores. RESULTS The 2 groups showed comparable grammatical skills across the 4 measures. Consistently significant associations between vocabulary size and grammatical outcomes were found in the CI group, with fewer associations in the NH group. CONCLUSIONS The 2 groups showed similar grammatical abilities. The young CI recipients appeared to be following a typical pattern of linguistic development.
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Rødvik AK, von Koss Torkildsen J, Wie OB, Storaker MA, Silvola JT. Consonant and Vowel Identification in Cochlear Implant Users Measured by Nonsense Words: A Systematic Review and Meta-Analysis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1023-1050. [PMID: 29623340 DOI: 10.1044/2018_jslhr-h-16-0463] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 12/18/2017] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of this systematic review and meta-analysis was to establish a baseline of the vowel and consonant identification scores in prelingually and postlingually deaf users of multichannel cochlear implants (CIs) tested with consonant-vowel-consonant and vowel-consonant-vowel nonsense syllables. METHOD Six electronic databases were searched for peer-reviewed articles reporting consonant and vowel identification scores in CI users measured by nonsense words. Relevant studies were independently assessed and screened by 2 reviewers. Consonant and vowel identification scores were presented in forest plots and compared between studies in a meta-analysis. RESULTS Forty-seven articles with 50 studies, including 647 participants, thereof 581 postlingually deaf and 66 prelingually deaf, met the inclusion criteria of this study. The mean performance on vowel identification tasks for the postlingually deaf CI users was 76.8% (N = 5), which was higher than the mean performance for the prelingually deaf CI users (67.7%; N = 1). The mean performance on consonant identification tasks for the postlingually deaf CI users was higher (58.4%; N = 44) than for the prelingually deaf CI users (46.7%; N = 6). The most common consonant confusions were found between those with same manner of articulation (/k/ as /t/, /m/ as /n/, and /p/ as /t/). CONCLUSIONS The mean performance on consonant identification tasks for the prelingually and postlingually deaf CI users was found. There were no statistically significant differences between the scores for prelingually and postlingually deaf CI users. The consonants that were incorrectly identified were typically confused with other consonants with the same acoustic properties, namely, voicing, duration, nasality, and silent gaps. A univariate metaregression model, although not statistically significant, indicated that duration of implant use in postlingually deaf adults predict a substantial portion of their consonant identification ability. As there is no ceiling effect, a nonsense syllable identification test may be a useful addition to the standard test battery in audiology clinics when assessing the speech perception of CI users.
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Affiliation(s)
- Arne Kirkhorn Rødvik
- Department of Special Needs Education, Faculty of Educational Sciences, University of Oslo, Norway
| | | | - Ona Bø Wie
- Department of Special Needs Education, Faculty of Educational Sciences, University of Oslo, Norway
- Oslo University Hospital, Norway
| | - Marit Aarvaag Storaker
- Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
- Lillehammer Hospital, Norway
| | - Juha Tapio Silvola
- Oslo University Hospital, Norway
- Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
- Akershus University Hospital, Lørenskog, Norway
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Goh BS, Fadzilah N, Abdullah A, Othman BF, Umat C. Long-term outcomes of Universiti Kebangsaan Malaysia Cochlear Implant Program among pediatric implantees. Int J Pediatr Otorhinolaryngol 2018; 105:27-32. [PMID: 29447813 DOI: 10.1016/j.ijporl.2017.11.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 11/19/2017] [Accepted: 11/21/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Cochlear implant (CI) greatly enhances auditory performance as compared to hearing aids and has dramatically affected the educational and communication outcomes for profoundly deaf children. Universiti Kebangsaan Malaysia (UKM) pioneered CI program in 1995 in the South East Asia. We would like to report the long-term outcomes of UKM paediatric cochlear implantation in terms of: the proportion of children who were implanted and still using the device, the children's modes of communication, their educational placements, and their functional auditory/oral performance. We also examined the factors that affected the outcomes measured. STUDY DESIGN This was a cross sectional observational study. METHODS Two sets of questionnaires were given to 126 parents or primary caregivers of the implantees. The first set of questionnaire contained questions to assess the children's usage of CI, their types of education placement, and their modes of communication. The second set of questionnaire was the Parent's Evaluation Of Aural/Oral Performance of Children (PEACH) to evaluate the children's auditory functionality. RESULTS Our study showed that among the implantees, 97.6% are still using their CI, 69.8% communicating orally, and 58.5% attending mainstream education. For implantees that use oral communication and attend mainstream education, their mean age of implantation is 38 months. This is significantly lower compared to the mean age of implantation of implantees that use non-oral communication and attend non-mainstream education. Simple logistic regression analysis shows age of implantation reliably predicts implantees (N = 126) would communicate using oral communication with odds ratio of 0.974, and also predict mainstream education (N = 118) with odds ratio of 0.967. The median score of PEACH rating scale is 87.5% in quiet, and this significantly correlates with an earlier age of implantation (r = -0.235 p = 0.048). CONCLUSIONS UKM Cochlear Implant Program has achieved reasonable success among the pediatric implantees, with better outcomes seen in those implanted at the age of less than 4 years old.
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Affiliation(s)
- Bee-See Goh
- Department of Otorhinolaryngology and Head and Neck Surgery, Level 9, Clinical Block, Hospital Canselor Tuanku Mukhriz, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia.
| | - Noraziana Fadzilah
- Department of Otorhinolaryngology, Hospital Sultanah Nora Ismail, Jalan Korma, Taman Soga, 83000 Batu Pahat, Johor, Malaysia
| | - Asma Abdullah
- Department of Otorhinolaryngology and Head and Neck Surgery, Level 9, Clinical Block, Hospital Canselor Tuanku Mukhriz, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Basyariatul Fathi Othman
- Institute of Ear, Hearing and Speech (Institute-HEARS), Block 8, 3rd Floor, Universiti Kebangsaan Malaysia, Jalan Temerloh, 53200 Kuala Lumpur, Malaysia
| | - Cila Umat
- School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
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Nicholas JG, Geers AE. Sensitivity of expressive linguistic domains to surgery age and audibility of speech in preschoolers with cochlear implants. Cochlear Implants Int 2017; 19:26-37. [PMID: 28992767 DOI: 10.1080/14670100.2017.1380114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To determine whether relative delays among domains exist in the conversational use of vocabulary, syntax, and morphology by children with cochlear implants (CIs) and whether these were differentially affected by age of implantation (AOI) and the audibility of speech. METHODS Participants in this short-term longitudinal study were 126 children with AOI of 6-38 months and a matched group of 30 children without hearing loss. Language samples of the same children at ages 3.5 and 4.5 were analyzed for the breadth of vocabulary and bound morphemes used, and sentence length. RESULTS At both test ages, expressive language domains were delayed equally. Higher performance across domains was independently associated with younger AOI and better pre-implant-aided thresholds. No domain was affected differently by very early implantation, but bound morpheme breadth was associated with better CI-aided thresholds. Between 63 and 78% of children with AOI of 6-11 months scored close to hearing age-mates by 4.5, a level achieved by fewer than 25% of those with AOI of 19-24 months or later ages. DISCUSSION Previous studies indicated greater language delays in the areas of morphology and syntax than those of vocabulary, with the earliest ages of implantation conferring the greatest benefit to those domains. The current design addressed inconsistency across studies in modes of communication used, presence/absence of other disabilities, and differences in language domains chosen as outcome measures. CONCLUSIONS Linguistic domains benefitted equally from early implantation, regardless of the duration of auditory stimulation. Better pre-CI-aided hearing often compensated for later AOI. Bound morpheme use was greater with better CI-aided thresholds.
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Affiliation(s)
- Johanna G Nicholas
- a Department of Otolaryngology , Washington University School of Medicine , Box 8115, 660 S. Euclid Ave., St. Louis , MO 63130 , USA
| | - Ann E Geers
- b School of Behavioral and Brain Sciences , The University of Texas at Dallas , GR41, 800 West Campbell Rd., Richardson , TX 75080 , USA
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Yaşar ÖC, Topbaş S. Profiling morpho-syntactical development of cochlear implanted children with TR-LARSP. CLINICAL LINGUISTICS & PHONETICS 2017; 32:181-192. [PMID: 28786695 DOI: 10.1080/02699206.2017.1334231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 05/21/2017] [Indexed: 06/07/2023]
Abstract
This research aims to describe the grammatical development of Turkish-speaking children with cochlear implants (CI) using the Turkish adaptation of the Language Assessment and Remediation Profile (LARSP). The study was conducted on a total of 15 children with CIs aged 43-87 months with 22-45 months of hearing age. A total of 750 utterances were elicited from the CI group's recorded speech samples and analysed using the methodology of Turkish-Language Assessment and Remediation Profile (TR-LARSP). A cross-sectional descriptive model is used in the study. The results show that there is a significant difference in the acquisition of grammatical structures in children with CIs as compared to typically developing (TD) age-matched children in Turkish. In conclusion, this study suggests that after the implantation of these children, the speech therapist should consider the acquisition time of morpho-syntactical structures before making a language-based therapy plan.
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Affiliation(s)
- Özlem Cangökçe Yaşar
- a Faculty of Health Sciences, Department of Speech and Language Therapy , Ondokuz Mayıs University, Samsun , Turkey
| | - Seyhun Topbaş
- b Faculty of Health Sciences, Department of Speech and Language Therapy , İstanbul Medipol University , İstanbul , Turkey
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Ciscare GKS, Mantello EB, Fortunato-Queiroz CAU, Hyppolito MA, Reis ACMBD. Auditory Speech Perception Development in Relation to Patient's Age with Cochlear Implant. Int Arch Otorhinolaryngol 2017; 21:206-212. [PMID: 28680487 PMCID: PMC5495590 DOI: 10.1055/s-0036-1584296] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 04/21/2016] [Indexed: 11/25/2022] Open
Abstract
Introduction A cochlear implant in adolescent patients with pre-lingual deafness is still a debatable issue. Objective The objective of this study is to analyze and compare the development of auditory speech perception in children with pre-lingual auditory impairment submitted to cochlear implant, in different age groups in the first year after implantation. Method This is a retrospective study, documentary research, in which we analyzed 78 reports of children with severe bilateral sensorineural hearing loss, unilateral cochlear implant users of both sexes. They were divided into three groups: G1, 22 infants aged less than 42 months; G2, 28 infants aged between 43 to 83 months; and G3, 28 older than 84 months. We collected medical record data to characterize the patients, auditory thresholds with cochlear implants, assessment of speech perception, and auditory skills. Results There was no statistical difference in the association of the results among groups G1, G2, and G3 with sex, caregiver education level, city of residence, and speech perception level. There was a moderate correlation between age and hearing aid use time, age and cochlear implants use time. There was a strong correlation between age and the age cochlear implants was performed, hearing aid use time and age CI was performed. Conclusion There was no statistical difference in the speech perception in relation to the patient's age when cochlear implant was performed. There were statistically significant differences for the variables of auditory deprivation time between G3 - G1 and G2 - G1 and hearing aid use time between G3 - G2 and G3 - G1.
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Affiliation(s)
- Grace Kelly Seixas Ciscare
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Erika Barioni Mantello
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carla Aparecida Urzedo Fortunato-Queiroz
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Miguel Angelo Hyppolito
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ana Cláudia Mirândola Barbosa dos Reis
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
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Colalto CA, Goffi-Gomez MVS, Magalhães ATDM, Samuel PA, Hoshino ACH, Porto BL, Tsuji RK. Vocabulário expressivo em crianças usuárias de implante coclear. REVISTA CEFAC 2017. [DOI: 10.1590/1982-021620171937216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: verificar a aquisição de vocabulário em crianças surdas, usuárias de implante coclear, bem como os fatores que influenciam esse desenvolvimento. Métodos: foi aplicada a parte de vocabulário do teste de linguagem infantil ABFW em 20 crianças usuárias de implante coclear por no mínimo três anos. Além disso, foi avaliada a participação familiar no desenvolvimento dessas crianças. Resultados: foi observado que as crianças implantadas apresentam possibilidade de alcançar o desenvolvimento normal de vocabulário, quando comparadas às crianças ouvintes, a depender de diversos fatores. O fator que apresentou influência estatisticamente significante no vocabulário foi a participação familiar, sendo que quanto maior o envolvimento da família no processo terapêutico, melhores os resultados no teste de vocabulário. Conclusão: as crianças implantadas podem apresentar desempenho similar às crianças ouvintes no teste de vocabulário, a depender das variáveis que transcendem a idade à implantação ou mesmo o tempo de uso do implante coclear. A estimulação/ participação familiar no desenvolvimento das crianças se mostrou de extrema importância no desenvolvimento da linguagem oral.
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Bruijnzeel H, Cattani G, Stegeman I, Topsakal V, Grolman W. Incorporating ceiling effects during analysis of speech perception data from a paediatric cochlear implant cohort. Int J Audiol 2017; 56:550-558. [DOI: 10.1080/14992027.2017.1311029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Hanneke Bruijnzeel
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands,
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands,
| | - Guido Cattani
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands,
| | - Inge Stegeman
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands,
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands,
| | - Vedat Topsakal
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Antwerp, Antwerp, Belgium, and
- Faculty of Medicine and Life Sciences, University of Antwerp, Antwerp, Belgium
| | - Wilko Grolman
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands,
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands,
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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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Kalejaiye A, Ansari G, Ortega G, Davidson M, Kim HJ. Low surgical complication rates in cochlear implantation for young children less than 1 year of age. Laryngoscope 2016; 127:720-724. [PMID: 27411677 DOI: 10.1002/lary.26135] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 05/18/2016] [Accepted: 05/23/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To identify risk factors for perioperative morbidity among a large national cohort of pediatric patients undergoing cochlear implantation. STUDY DESIGN Retrospective study utilizing the American College of Surgeons National Surgical Quality Improvement Program Pediatric database (2012-2013). METHODS Pediatric cochlear implantation cases were identified using current procedural terminology 69930. Patients were categorized by age, and operative characteristics along with 30-day perioperative outcomes were analyzed. RESULTS We identified 1,351 cases of pediatric cochlear implantation. The median age was 3.6 years, and 73 patients were less than 1 year of age. Of 21 complication occurrences (1.55%), superficial incisional surgical site infection (SSI) was the most common (n = 13, 61.9%). Thirty-nine patients (2.9%) required readmission. The median operative time was 142 minutes, and the mean postoperative length of stay was 0.58 days. When comparing patients younger than 1 year old to those 1 year or older, no significant differences were noted in complication rate, postoperative length of stay, or reoperation rate. Patients less than 1 year of age were more likely to be readmitted (6.9% vs. 2.7%, P = 0.04) and had longer mean operative times (191 minutes vs. 160 minutes, P = 0.0015). Steroid use was a risk factor for unplanned reoperation, SSI, and readmission. CONCLUSION Despite a slight increase in readmission rates and operative times among patients less than 1 year of age, cochlear implantation appears to be safe in this population, with complication rates, reoperation rates, and postoperative lengths of stay similar to children undergoing the procedure at the current U.S. Food and Drug Administration-approved age of 1 year and older. LEVEL OF EVIDENCE 4. Laryngoscope, 127:720-724, 2017.
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Affiliation(s)
- Adedoyin Kalejaiye
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Howard University College of Medicine, Washington, DC, U.S.A.,Department of Surgery, Clive O. Callender Howard-Harvard Multidisciplinary Outcomes Research Center and the Division of Otolaryngology-Head and Neck Surgery, Howard University Hospital, Washington, DC, U.S.A
| | - Ghedak Ansari
- Howard University College of Medicine, Washington, DC, U.S.A
| | - Gezzer Ortega
- Department of Surgery, Howard University College of Medicine, Washington, DC, U.S.A.,Department of Surgery, Clive O. Callender Howard-Harvard Multidisciplinary Outcomes Research Center and the Division of Otolaryngology-Head and Neck Surgery, Howard University Hospital, Washington, DC, U.S.A
| | | | - Hung Jeffrey Kim
- Department of Otolaryngology-Head and Neck Surgery, Medstar Georgetown University Hospital, Washington, DC, U.S.A
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Mikic B, Jotic A, Miric D, Nikolic M, Jankovic N, Arsovic N. Receptive speech in early implanted children later diagnosed with autism. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133 Suppl 1:S36-9. [DOI: 10.1016/j.anorl.2016.01.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 01/13/2016] [Indexed: 10/21/2022]
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