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Cornwall HL, Lam CM, Chaudhry D, Muzaffar J, Monksfield P, Bance ML. Outcomes of cochlear implantation in Usher syndrome: a systematic review. Eur Arch Otorhinolaryngol 2024; 281:1115-1129. [PMID: 37930386 PMCID: PMC10858075 DOI: 10.1007/s00405-023-08304-2] [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: 05/06/2023] [Accepted: 10/17/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE This study is a systematic review of the literature which seeks to evaluate auditory and quality of life (QOL) outcomes of cochlear implantation in patients with Usher syndrome. METHODS Systematic review of studies indexed in Medline via PubMed, Ovid EMBASE, Web of Science, CENTRAL and clinicaltrials.gov was performed up to March 9th 2022, conducted in accordance with the PRISMA statement. Patient demographics, comorbidity, details of cochlear implantation, auditory, and QOL outcomes were extracted and summarized. RESULTS 33 studies reported over 217 cochlear implants in 187 patients with Usher syndrome, comprising subtypes 1 (56 patients), 2 (9 patients), 3 (23 patients), and not specified (99 patients). Auditory outcomes included improved sound detection, speech perception, and speech intelligibility. QOL outcomes were reported for 75 patients, with benefit reported in the majority. CONCLUSIONS Many patients with Usher syndrome develop improved auditory outcomes after cochlear implantation with early implantation being an important factor.
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Affiliation(s)
| | - Chon Meng Lam
- Cardiff and Vale University Health Board, Cardiff, UK
| | - Daoud Chaudhry
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Jameel Muzaffar
- Department of Clinical Neurosciences, University of Cambridge, Level 3, A BlockCambridge Biomedical Campus, Box 165, Cambridge, CB2 0QQ, UK
- Department of Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Peter Monksfield
- Department of Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Manohar L Bance
- Department of Clinical Neurosciences, University of Cambridge, Level 3, A BlockCambridge Biomedical Campus, Box 165, Cambridge, CB2 0QQ, UK.
- Department of Otolaryngology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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Muller L, Goh BS, Cordovés AP, Sargsyan G, Sikka K, Singh S, Qiu J, Xu L, Graham PL, James CJ, Greenham P. Longitudinal outcomes for educational placement and quality of life in a prospectively recruited multinational cohort of children with cochlear implants. Int J Pediatr Otorhinolaryngol 2023; 170:111583. [PMID: 37245391 DOI: 10.1016/j.ijporl.2023.111583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/30/2023] [Accepted: 04/29/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVES The aim of this study was to report on the educational placement, quality of life and speech reception changes in a prospectively recruited group of children after they received a cochlear implant (CI). METHOD Data was collected on 1085 CI recipients of as part of a prospective, longitudinal, observational, international, multi-centre, paediatric registry, initiated by Cochlear Ltd (Sydney, NSW, Australia). Outcome data from children (≤10 years old) implanted in routine practice was voluntarily entered into a central, externally hosted, e-platform. Collection occurred prior to initial device activation (baseline) and at six monthly follow-up intervals up to 24 months and then at 3 years post activation. Clinician reported baseline and follow up questionnaires and Categories of Auditory Performance version II (CAP-II) outcomes were collated. Self-reported evaluation forms and patient information were provided by the parent/caregiver/patient via the implant recipient baseline and follow up, Children Using Hearing Implants Quality of Life (CuHIQoL) and Speech Spatial Qualities (SSQ-P) Parents Version questionnaires. RESULTS Children were mainly bilaterally profoundly deaf, unilaterally implanted and used a contralateral hearing aid. Prior to implant 60% used signing or total communication as their main mode of communication. Mean age at implant was 3.2 ± 2.2 years (range 0-10 years). At baseline 8.6% were in mainstream education with no additional support and 82% had not yet entered school. After three years of implant use, 52% had entered mainstream education with no additional support and 38% had not yet entered school. In the sub-group of 141 children who were implanted at or after three years of age and were thus old enough to be in mainstream school at the three-year follow up, an even higher proportion (73%) were in mainstream education with no support. Quality of life scores for the child improved statistically significantly post implant compared to baseline and continued to improve significantly at each interval up to 3 years (p < 0.001). Parental expectation scores reduced statistically significantly from baseline compared to all intervals (p < 0.028) and then increased significantly at 3 years compared to all post baseline follow-up intervals (p < 0.006). The impact on family life was reduced post implant compared to baseline and continued to reduce between annual intervals (p < 0.001). At three years post follow up median CAP II scores were 7 (IQR 6-7) and mean SSQ-P scores were 6.8 (SD1.9) 6.0 (SD1.9) and 7.4 (SD 2.3) for speech spatial and qualities scales respectively. SSQ-P and CAP II scores improved statistically and clinically significantly compared to baseline by one year post implantation. CAP II scores continued to improve at each test interval up to three years post implant. Speech and Qualities scores improved significantly between years 1 and 2 (p < 0.001), but only the Speech scores improved significantly between years 2 and 3 (p = 0.004). CONCLUSIONS Mainstream educational placement was achievable for most of the children, including those implanted at an older age. Quality of life for the child and the wider family improved. Future research could focus on the impact of mainstream school placement on children's academic progress, including measures of academic attainment and social functioning.
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Affiliation(s)
- Lida Muller
- Tygerberg Cochlear Implant Programme, South Africa.
| | - Bee See Goh
- University Kebangsaan Malaysia (UKM), Malaysia.
| | | | | | - Kapil Sikka
- All India Institute of Medical Sciences, New Delhi, India.
| | | | - Jianxin Qiu
- The First Affiliated Hospital of Anhui Medical University, China.
| | - Lei Xu
- Shandong Second Provincial General Hospital, China.
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Long GC, Umat C, Din NC. Socio-Emotional Development of Children with Cochlear Implant: A Systematic Review. Malays J Med Sci 2022; 28:10-33. [PMID: 35115884 PMCID: PMC8793967 DOI: 10.21315/mjms2021.28.5.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 10/26/2020] [Indexed: 11/02/2022] Open
Abstract
Background Attaining socio-emotional competence is challenging for children with hearing impairment. There is wide recognition of children with cochlear implant (CI) indicating significant improvement in their speech and language abilities, however many factors may restrict their chance of having reciprocal social interactions. A significant improvement in speech and language does not automatically affirm the quality of social interactions. This present observation on social-emotional development addressed a more current representative population of children with hearing loss who have benefitted from cochlear implantation. Methods The research conducted a systematic review of selected articles from Scopus and PubMed databases, retrieved through three search-process keywords, namely socio-emotional, children and CI. The inclusion criteria only included journal articles published in English with empirical data from the year 2010-2019. The initial search had identified 189 potential abstracts and after removal of duplicates, only 38 eligible studies met the inclusion criteria. Results Among 38 studies reviewed, 19 studies showed comparable socio-emotional skills with peers in social interaction, empathy, emotion theory of mind and comprehension skills. Conversely, the other 19 studies presented underprivileged results in socio-emotional functioning mainly in identifying facial expression, regulating emotion and emotional cues in the auditory domain. Conclusion This review concluded that the socio-emotional development among children with CI, both at preschool-age and school-age, was not justified due to the heterogeneity in studies across measurement and small sample size. Also, the conclusion recommended extensive cross-referencing, mixed-mode research design, detailed distinguishing of socio-emotional functioning and identification of diverse groups of the population with impaired hearing as an approach to provide empirical evidence on socio-emotional functioning among children with CI in the future.
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Affiliation(s)
- Geh Cha Long
- Centre for Rehabilitation & Special Needs Studies, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Cila Umat
- Centre for Rehabilitation & Special Needs Studies, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Centre for Rehabilitation & Special Needs Studies, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Abstract
Supplemental Digital Content is available in the text. Objectives: While the costs and outcomes of cochlear implantation (CI) have been widely assessed, most of these analyses were solely performed from the perspective of healthcare costs. This study assesses the costs and benefits of CI in the Netherlands from a broader societal perspective, including health outcomes, healthcare cost, educational cost, and productivity losses and gains. Design: The cost and benefits of CI were analyzed in this cost-benefit analysis, in which a monetary value is put on both the resources needed and the outcomes of CI. The costs and benefits were analyzed by prototypical instances of three groups, representing the majority of cochlear implant patients: prelingually deaf children implanted at the age of 1, adults with progressive profound hearing loss implanted at the age of 40 and seniors implanted at the age of 70 with progressive profound hearing loss. Costs and benefits were estimated over the expected lifetimes of the members of each group, using a Markov state transition model. Model parameters and assumptions were based on published literature. Probabilistic and one-way sensitivity analyses were performed. Results: In all three patient groups, the total benefits of CI exceeded the total cost, leading to a net benefit of CI. Prelingually deaf children with a bilateral CI had a lifetime positive outcome net benefit of €433,000. Adults and seniors with progressive profound hearing loss and a unilateral CI had a total net benefit of €275,000 and €76,000, respectively. These results ensue from health outcomes expressed in monetary terms, reduced educational cost, and increased productivity. Conclusions: Based on estimates from modeling, the increased healthcare costs due to CI were more than compensated by the value of the health benefits and by savings in educational and productivity costs. In particular, for children and working adults, the societal benefit was positive even without taking health benefits into account. Therefore, CI generates an advantage for both patients and society.
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Self-concept of children and adolescents with cochlear implants. Int J Pediatr Otorhinolaryngol 2021; 141:110506. [PMID: 33243619 DOI: 10.1016/j.ijporl.2020.110506] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 11/13/2020] [Accepted: 11/13/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Communicative disorders can complicate social interactions and may be detrimental for one's self-concept. This study aims to assess the self-concept of children with Cochlear Implants (CI). Results of educational peer groups (special needs or typical) were compared. Correlations amongst speech perception, language comprehension, self-concept and other study variables are determined. METHODS This retrospectively patient file study contained 53 CI participants with a mean age of 14.2 (SD = 2.8). Self-concept was measured with the Dutch language version of the Self-Perception Profile for Children and Adolescents. Proportions of low, normal and high competence scores were compared to a normative sample. Outcomes were analyzed for the total CI group and for the two educational peer groups. RESULTS In the Scholastic Competence, Athletic Competence, Physical Appearance and Behavioral Conduct domains larger proportions of high perceived competence levels were found in the CI Total group compared to the hearing normative sample. Children with CIs in the Mainstream educational subgroup were found to have larger proportions of high levels on these domains. Remarkably, children with CI in the Special hearing impaired educational subgroup reported comparable self-concept scores as their hearing peers. Speech perception and language comprehension were positively correlated to Scholastic Competence. CONCLUSION This study has shown that self-concept levels of profoundly hearing impaired children with CI are comparable to those of hearing peers. They are generally satisfied with their functioning in various domains. Better speech perception and language comprehension levels are related to higher outcomes in the Scholastic Competence domain.
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Misurelli SM, Goupell MJ, Burg EA, Jocewicz R, Kan A, Litovsky RY. Auditory Attention and Spatial Unmasking in Children With Cochlear Implants. Trends Hear 2020; 24:2331216520946983. [PMID: 32812515 PMCID: PMC7446264 DOI: 10.1177/2331216520946983] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The ability to attend to target speech in background noise is an important skill, particularly for children who spend many hours in noisy environments. Intelligibility improves as a result of spatial or binaural unmasking in the free-field for normal-hearing children; however, children who use bilateral cochlear implants (BiCIs) demonstrate little benefit in similar situations. It was hypothesized that poor auditory attention abilities might explain the lack of unmasking observed in children with BiCIs. Target and interferer speech stimuli were presented to either or both ears of BiCI participants via their clinical processors. Speech reception thresholds remained low when the target and interferer were in opposite ears, but they did not show binaural unmasking when the interferer was presented to both ears and the target only to one ear. These results demonstrate that, in the most extreme cases of stimulus separation, children with BiCIs can ignore an interferer and attend to target speech, but there is weak or absent binaural unmasking. It appears that children with BiCIs mostly experience poor encoding of binaural cues rather than deficits in ability to selectively attend to target speech.
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Affiliation(s)
- Sara M Misurelli
- Waisman Center, University of Wisconsin-Madison.,Department of Surgery, Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health
| | | | | | | | - Alan Kan
- Waisman Center, University of Wisconsin-Madison.,School of Engineering, Macquarie University, Sydney, Australia
| | - Ruth Y Litovsky
- Waisman Center, University of Wisconsin-Madison.,Department of Surgery, Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health
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Multicenter Study Investigating Foreign Language Acquisition at School in Children, Adolescents, and Young Adults With Uni- or Bilateral Cochlear Implants in the Swiss German Population. Otol Neurotol 2020; 41:e580-e587. [PMID: 32221106 DOI: 10.1097/mao.0000000000002607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Evaluation of foreign language acquisition at school in cochlear implant patients. STUDY DESIGN Multicenter cohort study. SETTING CI centers. PATIENTS One hundred twenty-five CI users (10-18 yr) in the German-speaking part of Switzerland were enrolled. Demographic data were obtained by means of written questionnaires. German-speaking children with mainstream foreign language tuition (English and/or French) were enrolled for further testing. The control group of normal-hearing individuals was matched on age, class, and number of foreign language lessons attended. RESULTS Overall, 100 questionnaires were returned. The 12 CI users without foreign language learning attended special schools. CI users who attended foreign language classes had better German speech comprehension compared with those without foreign language tuition (89 versus 51%; p < 0.05). Thirty-one CI users of different grades were further tested. All (10/10) CI 6th graders attained the school objectives for both English reading and listening skills. French performance at 6th grade for reading was 3/7 and for listening only 1/7. There were 13 matched normal-hearing pairs for English and 10 for French. The total scores were on average 7% higher, with a statistical significance for English reading (p < 0.05). CONCLUSIONS Almost 90% of CI children in Switzerland learn foreign language(s) at school. All the tested patients reached the current school objectives for English reading. The success rate for French was lower, especially regarding listening tasks. The 13 matched pairs with normal-hearing did not score substantially better.
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van Weerdenburg M, de Hoog BE, Knoors H, Verhoeven L, Langereis MC. Spoken language development in school-aged children with cochlear implants as compared to hard-of-hearing children and children with specific language impairment. Int J Pediatr Otorhinolaryngol 2019; 122:203-212. [PMID: 31048113 DOI: 10.1016/j.ijporl.2019.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 04/15/2019] [Accepted: 04/15/2019] [Indexed: 11/17/2022]
Affiliation(s)
| | - Brigitte E de Hoog
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands
| | - Harry Knoors
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands; Royal Dutch Kentalis, Sint-Michielsgestel, the Netherlands
| | - Ludo Verhoeven
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands; Royal Dutch Kentalis, Sint-Michielsgestel, the Netherlands
| | - Margreet C Langereis
- Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Radboud University Medical Center, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, the Netherlands
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Illg A, Haack M, Lesinski-Schiedat A, Büchner A, Lenarz T. Long-Term Outcomes, Education, and Occupational Level in Cochlear Implant Recipients Who Were Implanted in Childhood. Ear Hear 2017; 38:577-587. [DOI: 10.1097/aud.0000000000000423] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Single-Center Study Investigating Foreign Language Acquisition at School in Children, Adolescents, and Young Adults With Uni- or Bilateral Cochlear Implants in the Swiss German Population. Otol Neurotol 2017; 38:833-838. [PMID: 28419062 DOI: 10.1097/mao.0000000000001431] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate foreign language acquisition at school in cochlear implant patients. STUDY DESIGN Cohort study. SETTING CI center. PATIENTS Forty three cochlear implants (CI) patients (10-18 yr) were evaluated. CI nonusers and patients with CI-explantation, incomplete datasets, mental retardation, or concomitant medical disorders were excluded. INTERVENTION(S) Additional data (type of schooling, foreign language learning, and bilingualism) were obtained with questionnaires. German-speaking children with foreign tuition language (English and/or French) at school were enrolled for further testing. MAIN OUTCOME MEASURE(S) General patient data, auditory data, and foreign language data from both questionnaires and tests were collected and analyzed. RESULTS Thirty seven out of 43 questionnaires (86%) were completed. Sixteen (43%) were in mainstream education. Twenty-seven CI users (73%) have foreign language learning at school. Fifteen of these were in mainstream education (55%), others in special schooling. From 10 CI users without foreign language learning, one CI user was in mainstream education (10%) and nine patients (90%) were in special schooling. Eleven German-speaking CI users were further tested in English and six additionally in French. For reading skills, the school objectives for English were reached in 7 of 11 pupils (64%) and for French in 3 of 6 pupils (50%). For listening skills, 3 of 11 pupils (27%) reached the school norm in English and none in French. CONCLUSIONS Almost 75% of our CI users learn foreign language(s) at school. A small majority of the tested CI users reached the current school norm for in English and French in reading skills, whereas for hearing skills most of them were not able to reach the norm.
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Jacobs E, Langereis MC, Frijns JHM, Free RH, Goedegebure A, Smits C, Stokroos RJ, Ariens-Meijer SAM, Mylanus EAM, Vermeulen AM. Benefits of simultaneous bilateral cochlear implantation on verbal reasoning skills in prelingually deaf children. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 58:104-113. [PMID: 27608372 DOI: 10.1016/j.ridd.2016.08.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 08/29/2016] [Accepted: 08/30/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Impaired auditory speech perception abilities in deaf children with hearing aids compromised their verbal intelligence enormously. The availability of unilateral cochlear implantation (CI) auditory speech perception and spoken vocabulary enabled them to reach near ageappropriate levels. This holds especially for children in spoken language environments. However, speech perception in complex listening situations and the acquisition of complex verbal skills remains difficult. Bilateral CI was expected to enhance the acquisition of verbal intelligence by improved understanding of speech in noise. METHODS This study examined the effect of bilateral CI on verbal intelligence of 49 deaf children (3;5-8;0 years). Relations between speech perception in noise, auditory short-term memory and verbal intelligence were analysed with multiple linear regressions. In addition, the interaction of educational setting, mainstream or special, on these relations was analysed. RESULTS Children with bilateral CI obtained higher scores on verbal intelligence. Significant associations were present between speech perception in noise, auditory short-term memory and verbal intelligence. CONCLUSION Children with simultaneous bilateral CIs showed better speech perception in noise than children with unilateral CIs, which mediated by the auditory short-term memory capacity, enhanced the ability to acquire more complex verbal skills for BICI children in mainstream education.
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Affiliation(s)
- Evi Jacobs
- Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Margreet C Langereis
- Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Johan H M Frijns
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden Institute for Brain and Cognition, University Medical Center, Leiden, The Netherlands
| | - Rolien H Free
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Andre Goedegebure
- Department of Otorhinolaryngology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Cas Smits
- Department of Otorhinolaryngology, Audiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Robert J Stokroos
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Saskia A M Ariens-Meijer
- Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Emmanuel A M Mylanus
- Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Anneke M Vermeulen
- Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
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de Hoog BE, Langereis MC, van Weerdenburg M, Keuning J, Knoors H, Verhoeven L. Auditory and verbal memory predictors of spoken language skills in children with cochlear implants. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 57:112-124. [PMID: 27414061 DOI: 10.1016/j.ridd.2016.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 06/23/2016] [Accepted: 06/27/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Large variability in individual spoken language outcomes remains a persistent finding in the group of children with cochlear implants (CIs), particularly in their grammatical development. AIMS In the present study, we examined the extent of delay in lexical and morphosyntactic spoken language levels of children with CIs as compared to those of a normative sample of age-matched children with normal hearing. Furthermore, the predictive value of auditory and verbal memory factors in the spoken language performance of implanted children was analyzed. METHODS & PROCEDURES Thirty-nine profoundly deaf children with CIs were assessed using a test battery including measures of lexical, grammatical, auditory and verbal memory tests. Furthermore, child-related demographic characteristics were taken into account. OUTCOMES & RESULTS The majority of the children with CIs did not reach age-equivalent lexical and morphosyntactic language skills. Multiple linear regression analyses revealed that lexical spoken language performance in children with CIs was best predicted by age at testing, phoneme perception, and auditory word closure. The morphosyntactic language outcomes of the CI group were best predicted by lexicon, auditory word closure, and auditory memory for words. CONCLUSIONS Qualitatively good speech perception skills appear to be crucial for lexical and grammatical development in children with CIs. Furthermore, strongly developed vocabulary skills and verbal memory abilities predict morphosyntactic language skills.
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Affiliation(s)
- Brigitte E de Hoog
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands.
| | - Margreet C Langereis
- Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Marjolijn van Weerdenburg
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
| | - Jos Keuning
- Cito, P.O. Box 1034, 6801 MG Arnhem, The Netherlands
| | - Harry Knoors
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands; Royal Dutch Kentalis, P.O. Box 7, 5270 BA Sint-Michielsgestel, The Netherlands
| | - Ludo Verhoeven
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
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de Hoog BE, Langereis MC, van Weerdenburg M, Knoors HET, Verhoeven L. Linguistic profiles of children with CI as compared with children with hearing or specific language impairment. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2016; 51:518-530. [PMID: 26864995 DOI: 10.1111/1460-6984.12228] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/07/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND The spoken language difficulties of children with moderate or severe to profound hearing loss are mainly related to limited auditory speech perception. However, degraded or filtered auditory input as evidenced in children with cochlear implants (CIs) may result in less efficient or slower language processing as well. To provide insight into the underlying nature of the spoken language difficulties in children with CIs, linguistic profiles of children with CIs are compared with those of hard-of-hearing (HoH) children with conventional hearing aids and children with specific language impairment (SLI). AIMS To examine differences in linguistic abilities and profiles of children with CIs as compared with HoH children and children with SLI, and whether the spoken language difficulties of children with CIs mainly lie in limited auditory perception or in language processing problems. METHODS & PROCEDURE Differences in linguistic abilities and differential linguistic profiles of 47 children with CI, 66 HoH children with moderate to severe hearing loss, and 127 children with SLI are compared, divided into two age cohorts. Standardized Dutch tests were administered. Factor analyses and cluster analyses were conducted to find homogeneous linguistic profiles of the children. OUTCOMES & RESULTS The children with CIs were outperformed by their HoH peers and peers with SLI on most linguistic abilities. Concerning the linguistic profiles, the largest group of children with CIs and HoH children shared similar profiles. The profiles observed for most of the children with SLI were different from those of their peers with hearing loss in both age cohorts. CONCLUSIONS & IMPLICATIONS Results suggest that the underlying nature of spoken language problems in most children with CIs manifests in limited auditory perception instead of language processing difficulties. However, there appears to be a subgroup of children with CIs whose linguistic profiles resemble those of children with SLI.
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Affiliation(s)
- Brigitte E de Hoog
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500, HE Nijmegen, The Netherlands
| | - Margreet C Langereis
- Department of Otorhinolaryngology, Head and Neck Surgery, Hearing and Implants, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, P.O. Box 9101, 6500, HB Nijmegen, The Netherlands
| | - Marjolijn van Weerdenburg
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500, HE Nijmegen, The Netherlands
| | - Harry E T Knoors
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500, HE Nijmegen, The Netherlands
- Royal Dutch Kentalis, P.O. Box 7, 5270, BA Sint-Michielsgestel, The Netherlands
| | - Ludo Verhoeven
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500, HE Nijmegen, The Netherlands
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Huber M, Pletzer B, Giourgas A, Nickisch A, Kunze S, Illg A. Schooling Relates to Mental Health Problems in Adolescents with Cochlear Implants-Mediation by Hearing and Family Variables. Front Psychol 2015; 6:1889. [PMID: 26733898 PMCID: PMC4683195 DOI: 10.3389/fpsyg.2015.01889] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 11/23/2015] [Indexed: 12/27/2022] Open
Abstract
Aim of this multicenter study was to investigate whether schooling relates to mental health problems of adolescents with cochlear implants (CI) and how this relationship is mediated by hearing and family variables. One hundred and forty secondary school students with CI (mean age = 14.7 years, SD = 1.5), their hearing parents and teachers completed the Strengths and Difficulties Questionnaire (SDQ). Additional audiological tests (speech comprehension tests in quiet and noise) were performed. Students of special schools for hearing impaired persons (SSHIs) showed significantly more conduct problems (p < 0.05) and a significantly higher total difficulty score (TDS) (p < 0.05) compared to students of mainstream schools. Mental health problems did not differ between SSHI students with sign language education and SSHI students with oral education. Late implanted students and those with indication for additional handicaps were equally distributed among mainstream schools and SSHIs. However, students in SSHIs were more restricted to understand speech in noise, had a lower social background and were more likely to come from single-parent families. These factors were found to be partial mediators of the differences in mental health problems between the two school types. However, no variable could explain comprehensively, why students of SSHIs have more mental health problems than mainstream pupils.
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Affiliation(s)
- Maria Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University Salzburg Salzburg, Austria
| | - Belinda Pletzer
- Department of Psychology and Center for Neurocognitive Research, University of Salzburg Salzburg, Austria
| | - Alexandros Giourgas
- Department of Otorhinolaryngology, Hannover Medical School Hannover, Germany
| | - Andreas Nickisch
- Department of Hearing-Language-Cochlear Implants, kbo-Kinderzentrum München Munich, Germany
| | - Silke Kunze
- Department of Hearing-Language-Cochlear Implants, kbo-Kinderzentrum München Munich, Germany
| | - Angelika Illg
- Department of Otorhinolaryngology, Hannover Medical School Hannover, Germany
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