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Abstract
OBJECTIVES Children with hearing loss (HL), in spite of early cochlear implantation, often struggle considerably with language acquisition. Previous research has shown a benefit of rhythmic training on linguistic skills in children with HL, suggesting that improving rhythmic capacities could help attenuating language difficulties. However, little is known about general rhythmic skills of children with HL and how they relate to speech perception. The aim of this study is twofold: (1) to assess the abilities of children with HL in different rhythmic sensorimotor synchronization tasks compared to a normal-hearing control group and (2) to investigate a possible relation between sensorimotor synchronization abilities and speech perception abilities in children with HL. DESIGN A battery of sensorimotor synchronization tests with stimuli of varying acoustic and temporal complexity was used: a metronome, different musical excerpts, and complex rhythmic patterns. Synchronization abilities were assessed in 32 children (aged from 5 to 10 years) with a severe to profound HL mainly fitted with one or two cochlear implants (n = 28) or with hearing aids (n = 4). Working memory and sentence repetition abilities were also assessed. Performance was compared to an age-matched control group of 24 children with normal hearing. The comparison took into account variability in working memory capacities. For children with HL only, we computed linear regressions on speech, sensorimotor synchronization, and working memory abilities, including device-related variables such as onset of device use, type of device, and duration of use. RESULTS Compared to the normal-hearing group, children with HL performed poorly in all sensorimotor synchronization tasks, but the effect size was greater for complex as compared to simple stimuli. Group differences in working memory did not explain this result. Linear regression analysis revealed that working memory, synchronization to complex rhythms performances, age, and duration of device use predicted the number of correct syllables produced in a sentence repetition task. CONCLUSION Despite early cochlear implantation or hearing aid use, hearing impairment affects the quality of temporal processing of acoustic stimuli in congenitally deaf children. This deficit seems to be more severe with stimuli of increasing rhythmic complexity highlighting a difficulty in structuring sounds according to a temporal hierarchy.
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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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Lee SH, Huh MJ, Jeung HI. Receptive language skills of profoundly hearing-impaired children with cochlear implants. Cochlear Implants Int 2009; 5 Suppl 1:99-101. [PMID: 18792255 DOI: 10.1179/cim.2004.5.supplement-1.99] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Sang Heun Lee
- Department of Otolaryngology, College of Medicine, Kyungpook National University, Daegu, Korea.
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LYXELL BJÖRN, WASS MALIN, SAHLÉN BIRGITTA, SAMUELSSON CHRISTINA, ASKER-ÁRNASON LENA, IBERTSSON TINA, MÄKI-TORKKO ELINA, LARSBY BIRGITTA, HÄLLGREN MATHIAS. Cognitive development, reading and prosodic skills in children with cochlear implants. Scand J Psychol 2009; 50:463-74. [DOI: 10.1111/j.1467-9450.2009.00754.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lyxell B, Sahlén B, Wass M, Ibertsson T, Larsby B, Hällgren M, Mäki-Torkko E. Cognitive development in children with cochlear implants: Relations to reading and communication. Int J Audiol 2009; 47 Suppl 2:S47-52. [DOI: 10.1080/14992020802307370] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bond M, Elston J, Mealing S, Anderson R, Weiner G, Taylor R, Liu Z, Stein K. Effectiveness of multi-channel unilateral cochlear implants for profoundly deaf children: a systematic review. Clin Otolaryngol 2009; 34:199-211. [DOI: 10.1111/j.1749-4486.2009.01916.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Receptive Vocabulary Development in Deaf Children with Cochlear Implants: Achievement in an Intensive Auditory-Oral Educational Setting. Ear Hear 2009; 30:128-35. [PMID: 19125035 DOI: 10.1097/aud.0b013e3181926524] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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WASS MALIN, IBERTSSON TINA, LYXELL BJÖRN, SAHLÉN BIRGITTA, HÄLLGREN MATHIAS, LARSBY BIRGITTA, MÄKI-TORKKO ELINA. Cognitive and linguistic skills in Swedish children with cochlear implants - measures of accuracy and latency as indicators of development. Scand J Psychol 2008; 49:559-76. [DOI: 10.1111/j.1467-9450.2008.00680.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dettman SJ, Pinder D, Briggs RJS, Dowell RC, Leigh JR. Communication development in children who receive the cochlear implant younger than 12 months: risks versus benefits. Ear Hear 2007; 28:11S-18S. [PMID: 17496638 DOI: 10.1097/aud.0b013e31803153f8] [Citation(s) in RCA: 227] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The advent of universal neonatal hearing screening in some countries and the availability of screening programs for at-risk infants in other countries has facilitated earlier referral, diagnosis, and intervention for infants with hearing loss. Improvements in device technology, two decades of pediatric clinical experience, a growing recognition of the efficacy of cochlear implants for young children, and the recent change in the U.S. Food and Drug Administration's age criteria to include children as young as 12 mo has led to increasing numbers of young children receiving cochlear implants. Evidence to support provision for infants younger than 12 mo is extrapolated from physiological studies, studies of children using hearing aids, and studies of children older than 12 mo of age with implants. To date, however, there are few published research findings regarding communication development in children between 6 and 12 mo of age who receive implants. The current study hypothesized that earlier implantation would lead to increased rates of language acquisition as the children were still in the critical period for their development. METHOD A retrospective review was completed for 19 infants (mean age at implantation, 0.88 yr; range, 0.61-1.07, SD 0.15) and 87 toddlers (mean age at implantation, 1.60 yr; range, 1.13-2.00, SD 0.24) who received the multichannel implant in Melbourne, Australia. Preimplantation audiological assessments for these children included aided and unaided audiograms, auditory brain stem response, auditory steady state response (ASSR), and otoacoustic emission and indicated profound to total bilateral hearing loss in all cases. Communication assessment included completion of the Rossetti Infant-Toddler Language Scale and educational psychologists' cognitive and motor assessment. Computed tomography scan, magnetic resonance imaging, and surgical records for all cases were reviewed. Postimplantation language assessments were reported in terms of the rate of growth over time on the language comprehension and language expression subscales of the Rossetti Infant-Toddler Language Scale. RESULTS Results demonstrated that cochlear implantation may be performed safely in very young children with excellent language outcomes. The mean rates of receptive (1.12) and expressive (1.01) language growth for children receiving implants before the age of 12 mo were significantly greater than the rates achieved by children receiving implants between 12 and 24 mo, and matched growth rates achieved by normally hearing peers. These preliminary results support the provision of cochlear implants for children younger than 12 mo of age within experienced pediatric implantation centers.
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Kanda Y, Yoshida H, Ogata E, Miyamoto I, Adachi N, Tateoka A, Takeda N, Takahashi H. Word and speech perception results of 103 cases with cochlear implants at Nagasaki University. Cochlear Implants Int 2004; 5 Suppl 1:101-3. [DOI: 10.1179/cim.2004.5.supplement-1.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Lee SH, Huh MJ, Jeung HI. Receptive language skills of profoundly hearing-impaired children with cochlear implants. Cochlear Implants Int 2004. [DOI: 10.1002/cii.187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Zwolan TA, Ashbaugh CM, Alarfaj A, Kileny PR, Arts HA, El-Kashlan HK, Telian SA. Pediatric Cochlear Implant Patient Performance as a Function of Age at Implantation. Otol Neurotol 2004; 25:112-20. [PMID: 15021769 DOI: 10.1097/00129492-200403000-00006] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to examine the effect that age at implantation has on performance of children who received multichannel cochlear implants. STUDY DESIGN This is a retrospective study of 295 children who were broken down into 5 age groups based on age at implantation: 1-3 years, 3-5 years, 5-7 years, 7-9 years, and 9-11 years. Speech perception test scores obtained 12, 24, and 36 months postactivation were compared for the 5 groups using repeated-measures analysis of variance. SETTING This study was carried out at a tertiary academic medical center. PATIENTS Subjects consisted of 295 children who ranged in age from 12 months to 10 years 11 months at the time they obtained their cochlear implant. INTERVENTION All patients received their cochlear implant at a single implant facility. MAIN OUTCOME MEASURES Performance on several speech perception tests was compared 12, 24, and 36 months postactivation. Performance was evaluated as a function of age at implantation. RESULTS Patients in all 5 groups demonstrated improved scores when compared with scores obtained preoperatively with hearing aids. Repeated-measures analysis of variance (ANOVA) revealed a significant group by time interaction for 3 of the 5 measures. For all three of these measures, children implanted at younger ages demonstrated greater gains in speech perception over time than children implanted at older ages. CONCLUSIONS These results are in agreement with those of previous studies indicating that early implantation facilitates improved development of speech perception skills in profoundly deaf children.
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Affiliation(s)
- T A Zwolan
- University of Michigan Cochlear Implant Program, Ann Arbor, Michigan 48108, USA.
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El-Hakim H, Papsin B, Mount RJ, Levasseur J, Panesar J, Stevens D, Harrison RV. Vocabulary acquisition rate after pediatric cochlear implantation and the impact of age at implantation. Int J Pediatr Otorhinolaryngol 2001; 59:187-94. [PMID: 11397500 DOI: 10.1016/s0165-5876(01)00481-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE studies of early vocabulary development after pediatric cochlear implantation show growth rates that approach normality. Do these growth rates continue to rise over time and, therefore, allow a 'catch up' with ideal scores for age, or do they decline after an initial peak. Could age at implantation be a decisive factor in that process? DESIGN retrospective study (mean follow-up 4 years). PATIENTS pre-lingually deaf children implanted between 1988 and1999, who serially performed Peabody Picture Vocabulary Test-Revised (PPVT), (37 patients) and Expressive One-word Picture Vocabulary Test-Revised (EOWPVT), (35 patients). OUTCOME MEASURES the mean rates of age equivalent scores were determined for the whole follow-up period and analyzed further for two post-implant periods (the two halves of follow-up duration of individual patients). After sub-grouping by age at implantation (younger or older than 5 years old), the same analysis was executed for each subgroup. RESULTS the mean EOWPVT rate of the earlier period was higher than that of the later period (1.33 vs. 0.67, P<0.01) and the mean PPVT rate of the earlier period was higher than that of the later period (0.72 vs. 0.5). The latter difference was not statistically significant (P>0.05). Within subgroups by age at implantation, the PPVT mean rates were stable for younger implanted patients (0.56 for both periods) and dropped for the older implanted sub-group (0.87-0.43, P>0.05). The EOWPVT mean rates declined significantly for the older patients group (1.72-0.55, P<0.01) but insignificantly for the younger patients (0.99-0.77, P>0.05). CONCLUSIONS vocabulary acquisition rates decline in the post-implantation period. This is more pronounced with older implanted children and the EOWPVT rates. This information on the time course development of vocabulary after implantation would be valuable in counseling and planning habilitation in addition to candidate selection.
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Affiliation(s)
- H El-Hakim
- Department of Otolaryngology, The Hospital for Sick Children, 555 University Avenue, M5G 1X8, Toronto, Canada.
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Gordon KA, Daya H, Harrison RV, Papsin BC. Factors contributing to limited open-set speech perception in children who use a cochlear implant. Int J Pediatr Otorhinolaryngol 2000; 56:101-11. [PMID: 11115683 DOI: 10.1016/s0165-5876(00)00400-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Cochlear implants have enabled many children with severe to profound sensorineural hearing loss to develop speech perception skills. However, some children experience few gains while others develop high levels of speech perception. We identified potential factors contributing to poor performance with an implant by studying implanted children who do not develop functional speech perception. Five children were identified as developing no open-set word recognition skills after at least 2 years of implant use. This study group was compared to a randomly selected control group (n=10) and an age-matched control group (n=5). Pre-implant factors were examined using a Graded Profile Analysis and post-implant factors were assessed in a retrospective chart review. A greater number of pre-implant concerns were raised in the study group than in randomized controls (P<0.01). Chronological age and duration of deafness were pre-implant concerns in all study group subjects. A greater number of post-implant concerns were found in the study group than in randomly selected controls (P<0.005). We conclude that while appropriate selection of candidates for cochlear implantation is important in predicting speech perception outcomes, post-implant follow-up is also essential and must include regular monitoring of equipment, monitoring of stimulation levels with use of objective measures of stimulation levels if necessary, and consistent habilitation.
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Affiliation(s)
- K A Gordon
- Department of Otolaryngology and the Cochlear Implant Program, The Hospital for Sick Children, 555 University Avenue, M5G 1X8, Toronto, ON, Canada
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Ponton CW, Eggermont JJ, Don M, Waring MD, Kwong B, Cunningham J, Trautwein P. Maturation of the mismatch negativity: effects of profound deafness and cochlear implant use. Audiol Neurootol 2000; 5:167-85. [PMID: 10859411 DOI: 10.1159/000013878] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The use of cochlear implants to restore auditory sensation in deaf children is increasing, with a trend toward earlier implantation. However, little is known about how auditory deprivation and subsequent cochlear implant use affect the maturing human central auditory system. Our previous studies have demonstrated that the obligatory auditory evoked potentials (AEPs) of implanted children are very different from those of normal-hearing children. Unlike the obligatory potentials, which primarily reflect neural responses to stimulus onset, the mismatch negativity (MMN) provides a neurophysiological measure of auditory short-term memory and discrimination processes. The purpose of this investigation is to review our studies of the effects of auditory deprivation due to profound deafness and cochlear implant use on the maturation of the MMN in children, placed in the context of overall age-related changes in the AEPs. The development and application of a statistical technique to assess the MMN in individuals is also reviewed. Results show that although the morphology of the obligatory AEPs is substantially altered by the absence of a normal N(1) peak, the MMN is robustly present in a group of implanted children who have good spoken language perception through their device. Differences exist in the scalp distribution of the MMN between implanted and normal-hearing children. Specifically, the MMN appears to be more symmetrical in amplitude over both hemispheres, whereas it is initially much larger over the contralateral hemisphere in normal-hearing children. These findings suggest that, compared to N(1), the MMN is a better measure of basic auditory processes necessary for the development of spoken language perception skills in profoundly deaf children and adults who use a cochlear implant.
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Affiliation(s)
- C W Ponton
- Electrophysiology Laboratory, House Ear Institute, Los Angeles, CA 90057, USA.
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Speech perception in congenitally hearing impaired children using cochlear implants. Curr Opin Otolaryngol Head Neck Surg 1999. [DOI: 10.1097/00020840-199910000-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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