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Majorano M, Santangelo M, Redondi I, Barachetti C, Florit E, Guerzoni L, Cuda D, Ferrari R, Bertelli B. The use of a computer-based program focused on the syllabic method to support early literacy in children with cochlear implants. Int J Pediatr Otorhinolaryngol 2024; 183:112048. [PMID: 39068706 DOI: 10.1016/j.ijporl.2024.112048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 07/11/2024] [Accepted: 07/22/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Children with cochlear implants (CIs) often lag behind children with normal hearing (NH) in early literacy skills. Furthermore, the development of language skills associated with their emergent literacy skills seems to depend on good auditory access. Supporting language acquisition and early literacy in children with CIs may prevent difficulties in primary school. The use of technology may facilitate auditory and speech recovery in children with CIs, but evidence on computer-based early literacy programs is limited. OBJECTIVE This study investigates (a) the effects of a computer-based program focusing on the syllabic method on the literacy skills of children with CIs (CIs group), comparing them with the literacy skills of a group of age-matched NH (normal hearing) peers (NHs group); (b) the associations between language and early literacy skills in the NHs group and between language, auditory and early literacy skills in the CIs group. METHOD Nine prelingually deaf children with CIs (M = 61.11, SD = 6.90) with severe to profound sensorineural hearing loss and nine age-matched NH children participated in the program. Categories of Auditory Performance (CAP) as measures of children's auditory skills were collected. All participants were tested on phonological, morphosyntax (grammatical comprehension and repetition), and early literacy skills (syllable blending and segmentation, syllable and word reading) (T1). Next, all children participated in the computer-based program for 12 weeks. After the program was completed (T2), only early literacy tests were administered to the children. RESULTS Although, on average, both groups obtained higher scores in all literacy tasks at T2, the CIs group scored lower than the NHs group. In the CIs group, at T2 we found significant improvements in syllable segmentation (p = 0.042) and word reading (p = 0.035). In the NHs group, at T2 we found significant improvements in syllable segmentation (p = 0.034), syllable blending (p = 0.022), syllable reading (p = 0.008), and word reading (p = 0.009). We also found significant associations in both groups between measures of morphosyntax at T1 and measures of early literacy at T2. In addition, for the CIs group, we found significant associations between children's auditory performance at T1 and measures of morphosyntax at T1 and early literacy at T2. CONCLUSION a computer-based program focused on the syllabic method could support children with CIs in acquiring emergent literacy abilities. The auditory performance of children with CIs seems to influence their morphosyntax and later early literacy skills.
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Affiliation(s)
| | | | - Irene Redondi
- Department of Human Sciences, University of Verona, Italy
| | | | - Elena Florit
- Department of Human Sciences, University of Verona, Italy
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Luo J, Xu L, Wang M, Li J, He S, Spencer L, Liu HM, Guo LY. The Contribution of Noun and Verb Lexicon Sizes to Later Grammatical Outcomes in Mandarin-Speaking Children With Cochlear Implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024:1-13. [PMID: 39018252 DOI: 10.1044/2024_jslhr-24-00131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
PURPOSE The present study evaluated the applicability of the sentence-focused framework to Mandarin-speaking children with cochlear implants (CIs) by examining the relative contribution of receptive/expressive noun and verb lexicon sizes to later grammatical complexity. METHOD Participants were 51 Mandarin-speaking children who received cochlear implantation before 30 months of age. At 12 months after CI activation, parents were asked to endorse words that their child could understand only or understand and say using the infant version of the Early Vocabulary Inventory. At 24 months after CI activation, parents were asked to endorse the grammatical structures that their children were able to say using the Grammatical Complexity subtest in the Mandarin Communicative Development Inventory-Taiwan. Children's receptive/expressive noun and verb lexicon sizes and grammatical complexity scores were computed from these parent checklists. RESULTS Correlational analyses showed that children's receptive/expressive noun and verb lexicon sizes at 12 months after CI activation were all highly correlated with their grammatical complexity scores at 24 months after CI activation (ρs = .52-.63, ps < .001). Regression analyses further revealed that verb lexicon sizes at 12 months after CI activation outweighed noun lexicon sizes in accounting for grammatical complexity at 24 months after CI activation. CONCLUSIONS Our findings supported the prediction of the sentence-focused framework. Emphasizing the role of verbs in early intervention has the potential to enhance grammatical outcomes in Mandarin-speaking children with CIs. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.26129044.
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Affiliation(s)
- Jianfen Luo
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Lei Xu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Min Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Jinming Li
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Shandong University, Jinan, China
| | - Shuman He
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus
| | - Linda Spencer
- MSSLP Program, Rocky Mountain University of Health Professions, Provo, UT
| | - Huei-Mei Liu
- Department of Special Education, National Taiwan Normal University, Taipei, Taiwan
- Institute for Research Excellence in Learning Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - Ling-Yu Guo
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan
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Chu CY, Chen PH, Tsai YS, Chen CA, Chan YC, Ciou YJ. Effect of sample length on MLU in Mandarin-speaking hard-of-hearing children. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024; 29:388-395. [PMID: 38409766 DOI: 10.1093/deafed/enae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 11/14/2023] [Accepted: 01/22/2024] [Indexed: 02/28/2024]
Abstract
This study investigated the impact of language sample length on mean length of utterance (MLU) and aimed to determine the minimum number of utterances required for a reliable MLU. Conversations were collected from Mandarin-speaking, hard-of-hearing and typical-hearing children aged 16-81 months. The MLUs were calculated using sample sizes ranging from 25 to 200 utterances. The results showed that for an MLU between 1.0 and 2.5, 25 and 50 utterances were sufficient for reliable MLU calculations for hard-of-hearing and typical-hearing children, respectively. For an MLU between 2.5 and 3.75, 125 utterances were required for both groups. For an MLU greater than 3.75, 150 and 125 utterances were required for hard-of-hearing and typical-hearing children, respectively. These findings suggest that a greater number of utterances are required for a reliable MLU as language complexity increases. Professionals working with hard-of-hearing children should consider collecting different numbers of utterances based on the children's language complexity levels.
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Affiliation(s)
- Chia-Ying Chu
- Speech and Hearing Science Research Institute, Children's Hearing Foundation, Taipei City 114, Taiwan
| | - Pei-Hua Chen
- Speech and Hearing Science Research Institute, Children's Hearing Foundation, Taipei City 114, Taiwan
| | - Yi-Shin Tsai
- Speech and Hearing Science Research Institute, Children's Hearing Foundation, Taipei City 114, Taiwan
| | - Chieh-An Chen
- Speech and Hearing Science Research Institute, Children's Hearing Foundation, Taipei City 114, Taiwan
| | - Yi-Chih Chan
- Speech and Hearing Science Research Institute, Children's Hearing Foundation, Taipei City 114, Taiwan
| | - Yan-Jhe Ciou
- Speech and Hearing Science Research Institute, Children's Hearing Foundation, Taipei City 114, Taiwan
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Deroche MLD, Wolfe J, Neumann S, Manning J, Hanna L, Towler W, Wilson C, Bien AG, Miller S, Schafer E, Gemignani J, Alemi R, Muthuraman M, Koirala N, Gracco VL. Cross-modal plasticity in children with cochlear implant: converging evidence from EEG and functional near-infrared spectroscopy. Brain Commun 2024; 6:fcae175. [PMID: 38846536 PMCID: PMC11154148 DOI: 10.1093/braincomms/fcae175] [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] [Received: 10/18/2023] [Revised: 04/02/2024] [Accepted: 05/17/2024] [Indexed: 06/09/2024] Open
Abstract
Over the first years of life, the brain undergoes substantial organization in response to environmental stimulation. In a silent world, it may promote vision by (i) recruiting resources from the auditory cortex and (ii) making the visual cortex more efficient. It is unclear when such changes occur and how adaptive they are, questions that children with cochlear implants can help address. Here, we examined 7-18 years old children: 50 had cochlear implants, with delayed or age-appropriate language abilities, and 25 had typical hearing and language. High-density electroencephalography and functional near-infrared spectroscopy were used to evaluate cortical responses to a low-level visual task. Evidence for a 'weaker visual cortex response' and 'less synchronized or less inhibitory activity of auditory association areas' in the implanted children with language delays suggests that cross-modal reorganization can be maladaptive and does not necessarily strengthen the dominant visual sense.
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Affiliation(s)
- Mickael L D Deroche
- Department of Psychology, Concordia University, Montreal, Quebec, Canada, H4B 1R6
| | - Jace Wolfe
- Hearts for Hearing Foundation, Oklahoma City, OK 73120, USA
| | - Sara Neumann
- Hearts for Hearing Foundation, Oklahoma City, OK 73120, USA
| | - Jacy Manning
- Hearts for Hearing Foundation, Oklahoma City, OK 73120, USA
| | - Lindsay Hanna
- Hearts for Hearing Foundation, Oklahoma City, OK 73120, USA
| | - Will Towler
- Hearts for Hearing Foundation, Oklahoma City, OK 73120, USA
| | - Caleb Wilson
- Department of Otolaryngology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Alexander G Bien
- Department of Otolaryngology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Sharon Miller
- Department of Audiology & Speech-Language Pathology, University of North Texas, Denton, TX 76201, USA
| | - Erin Schafer
- Department of Audiology & Speech-Language Pathology, University of North Texas, Denton, TX 76201, USA
| | - Jessica Gemignani
- Department of Developmental and Social Psychology, University of Padova, 35131 Padua, Italy
| | - Razieh Alemi
- Department of Psychology, Concordia University, Montreal, Quebec, Canada, H4B 1R6
| | - Muthuraman Muthuraman
- Section of Neural Engineering with Signal Analytics and Artificial Intelligence, Department of Neurology, University Hospital Würzburg, 97080 Würzburg, Germany
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Bongioletti J, Doble M, Purcell A. Conversation and pragmatics in children who are hard-of-hearing: a scoping review. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024:enae011. [PMID: 38757199 DOI: 10.1093/deafed/enae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/05/2024] [Accepted: 02/21/2024] [Indexed: 05/18/2024]
Abstract
Technological and therapeutic advances have allowed many children who are born hard-of-hearing (HoH) to start school with age-appropriate spoken language skills, yet many of these children continue to find everyday conversations challenging. This scoping review maps the evidence related to development of conversation and pragmatic skills in children who are HoH and learning spoken language. The review followed Arksey and O'Malley's methodological framework and the PRISMA Extension for Scoping Reviews guidelines. Quality appraisal, data extraction, and thematic analysis were used to describe the data. Systematic searches identified 36 articles for inclusion. Sample sizes were small and heterogenous. Most studies focused on school-aged children with severe hearing loss or greater. Methodological rigor varied. Thematic analysis revealed two global themes. First, children who are HoH continue to find conversation and pragmatics difficult to master, and second, there are a set of audiological, communication, environmental, and demographic characteristics that are associated with better conversation and pragmatic outcomes, some of which are fixed, whereas others are malleable. Focused attention on designing valid and reliable assessments for conversation and pragmatic skills, and on developing therapeutic approaches targeting early conversation and pragmatic skill development, is needed to reduce the impact conversation and pragmatic differences across the lifespan.
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Affiliation(s)
- Jenna Bongioletti
- Faculty of Medicine and Health, Discipline of Speech Pathology, The University of Sydney, Camperdown, NSW, Australia
| | - Maree Doble
- Faculty of Medicine and Health, Discipline of Speech Pathology, The University of Sydney, Camperdown, NSW, Australia
| | - Alison Purcell
- School of Health Sciences, Speech Pathology, Western Sydney University, Campbelltown, NSW, Australia
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Wainscott SD, Spurgin K. Differentiating Language for Students Who Are Deaf or Hard of Hearing: A Practice-Informed Framework for Auditory and Visual Supports. Lang Speech Hear Serv Sch 2024; 55:473-494. [PMID: 38324382 DOI: 10.1044/2023_lshss-22-00088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024] Open
Abstract
PURPOSE Speech-language pathologists (SLPs) serving students who are d/Deaf or hard of hearing (Deaf/hh) and their deaf education counterparts must navigate complexities in language that include modalities that are spoken or signed and proficiency, which is often compromised. This tutorial describes a practice-informed framework that conceptualizes and organizes a continuum of auditory and visual language supports with the aim of informing the practice of the SLP whose training is more inherently focused on spoken language alone, as well as the practice of the teacher of the Deaf/hh (TDHH) who may focus more on visual language supports. METHOD This product resulted from a need within interdisciplinary, graduate programs for SLPs and TDHHs. Both cohorts required preparation to address the needs of diverse language learners who are Deaf/hh. This tutorial includes a brief review of the challenges in developing language proficiency and describes the complexities of effective service delivery. The process of developing a practice-informed framework for language supports is summarized, referencing established practices in auditory-based and visually based methodologies, identifying parallel practices, and summarizing the practices within a multitiered framework called the Framework of Differentiated Practices for Language Support. Recommendations for use of the framework include guidance on the identification of a student's language modality/ies and proficiency to effectively match students' needs and target supports. CONCLUSIONS An examination of established practices in language supports across auditory and visual modalities reveals clear parallels that can be organized into a tiered framework. The result is a reference for differentiating language for the interdisciplinary school team. The parallel supports also provide evidence of similarities in practice across philosophical boundaries as professionals work collaboratively.
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Affiliation(s)
- Sarah D Wainscott
- Department of Communication Sciences and Oral Health, Texas Woman's University, Denton
| | - Kelsey Spurgin
- Department of Special Education, Ball State University, Muncie, IN
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Carden KC, McWilliam RA, McLeod RH, Fedewa MP. Narrative Intervention for Preschoolers Who Are Deaf and Hard of Hearing Using Listening and Spoken Language: A Pilot Study. Lang Speech Hear Serv Sch 2024; 55:510-528. [PMID: 38215241 DOI: 10.1044/2023_lshss-23-00063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024] Open
Abstract
PURPOSE This pilot study aimed to examine the effects of a caregiver-supported, narrative-based intervention program on the story retelling skills of a group of preschoolers who are deaf and hard of hearing (D/HH) using listening and spoken language (LSL). METHOD A concurrent multiple baseline design across participants was used to determine the effect of a narrative intervention on the story retelling skills of three preschool-age participants who demonstrated complex language delays. Their primary caregivers also functioned as participants. The 6-week narrative intervention program was implemented using a caregiver coaching model during individual therapy sessions. The dependent variable probes were administered twice per week across phases to assess the preschool participants' story retelling skills, including story grammar, complexity, and completeness. Social validity was also evaluated using a caregiver questionnaire. RESULTS A functional relation was demonstrated between the intervention and story retelling across all three preschool participants with notable increases in the inclusion of story grammar elements and episodic completeness. All three participants maintained scores above baseline levels on dependent variable probes across the 6-week maintenance period. Social validity was strong according to the results of a caregiver questionnaire completed at the conclusion of the intervention. CONCLUSION These findings offer preliminary support for the use of a caregiver-supported, narrative-based intervention program to improve storytelling and retelling skills in preschoolers who are D/HH using LSL.
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Affiliation(s)
- Kameron C Carden
- Department of Special Education and Multiple Abilities, University of Alabama, Tuscaloosa
| | - Robin A McWilliam
- Department of Special Education and Multiple Abilities, University of Alabama, Tuscaloosa
| | - Ragan H McLeod
- Department of Special Education and Multiple Abilities, University of Alabama, Tuscaloosa
| | - Megan P Fedewa
- Department of Special Education and Multiple Abilities, University of Alabama, Tuscaloosa
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Illg A, Adams D, Lesinski-Schiedat A, Lenarz T, Kral A. Variability in Receptive Language Development Following Bilateral Cochlear Implantation. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:618-632. [PMID: 38198368 DOI: 10.1044/2023_jslhr-23-00297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVES The primary aim was to investigate the variability in language development in children aged 5-7.5 years after bilateral cochlear implantation (CI) up to the age of 2 years, and any impact of the age at implantation and additional noncognitive or anatomical disorders at implantation. DESIGN Data of 84 congenitally deaf children that had received simultaneous bilateral CI at the age of ≤ 24 months were included in this retrospective study. The results of language comprehension acquisition were evaluated using a standardized German language acquisition test for normal hearing preschoolers and first graders. Data on speech perception of monosyllables and sentences in quiet and noise were added. RESULTS In a monosyllabic test, the children achieved a median performance of 75.0 ± 12.88%. In the sentence test in quiet, the median performance was 89 ± 12.69%, but dropped to 54 ± 18.92% in noise. A simple analysis showed a significant main effect of age at implantation on monosyllabic word comprehension (p < .001), but no significant effect of comorbidities that lacked cognitive effects (p = .24). Language acquisition values correspond to the normal range of children with normal hearing. Approximately 25% of the variability in the language acquisition tests is due to the outcome of the monosyllabic speech perception test. CONCLUSIONS Congenitally deaf children who were fitted bilaterally in the 1st year of life can develop age-appropriate language skills by the time they start school. The high variability in the data is partly due to the age of implantation, but additional factors such as cognitive factors (e.g., working memory) are likely to influence the variability.
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Affiliation(s)
- Angelika Illg
- Department of Otolaryngology, Medical University Hannover, Germany
| | - Doris Adams
- Department of Otolaryngology, Medical University Hannover, Germany
| | | | - Thomas Lenarz
- Department of Otolaryngology, Medical University Hannover, Germany
| | - Andrej Kral
- Department of Otolaryngology, Medical University Hannover, Germany
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Mieres D, Losilla JM, Pérez E, Cambra C. Linguistic Intervention Strategies Speech-Language Pathologists Use With Children Using Cochlear Implants. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2023; 29:60-71. [PMID: 38124680 DOI: 10.1093/deafed/enad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 12/23/2023]
Abstract
The aim of this study was to explore the strategies that speech-language pathologists (SLPs) use during their linguistic interventions on children with cochlear implants (CIs). The sample comprised 7 SLPs in interactions with 62 children, 31 with CIs and 31 with typical hearing (TH), from 5 to 7 years of age. Two linguistic activities were used: conversation and naming. With children with CIs, the SLPs used 3.8 times more adaptation strategies and 5 times more educational strategies in the conversation activity, and 1.4 times more educational strategies in the naming activity than with children with TH. Communication strategies were significantly more frequent in the conversation activity than in the naming activity while educational strategies were more frequent in the naming activity than in the conversation activity. The auditory age of children with CIs also influenced the use of these two types of strategies, increasing the use of communication strategies by 0.6% and decreasing the use of educational strategies by 1.2% for each month of increase in the auditory age. In order to foster linguistic development, the SLPs used a wide variety of strategies with the children with CIs, adjusting them to the activity and the auditory age.
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Affiliation(s)
- Daniela Mieres
- Department of Basics, Developmental and Educational Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josep-Maria Losilla
- Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Encarna Pérez
- Department of Basics, Developmental and Educational Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Cambra
- Department of Basics, Developmental and Educational Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
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de Jong TJ, van der Schroeff MP, Achterkamp MD, Vroegop JL. First results of the Strengths and Difficulties Questionnaire, applied as a screening tool for psychosocial difficulties in pediatric audiology. Eur Arch Otorhinolaryngol 2023; 280:4467-4476. [PMID: 37083817 PMCID: PMC10477219 DOI: 10.1007/s00405-023-07979-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
PURPOSE Despite major improvements in rehabilitation possibilities, children with sensorineural hearing loss are at risk for psychosocial difficulties. These difficulties can impact their educational and career achievements and may be two to three times more common in children with hearing loss compared to those with normal hearing. Early identification of psychosocial difficulties can be facilitated using the Strengths and Difficulties Questionnaire (SDQ) and may improve outcomes and quality of life. We implemented the SDQ into the clinical follow-up of children with hearing loss in a tertiary referral hospital. With this, prevalence and severity of difficulties in specific psychosocial domains and several predictors were investigated. METHODS A retrospective, cross-sectional investigation was performed of the following factors in association with the SDQ results: type of hearing device, type and degree of hearing loss, speech perception in quiet and in noise, and type of schooling. RESULTS Between June 2020 and January 2022, parents of 312 children (age 4-18) completed the SDQ. An additional 113 child-reports were completed. The response rate of the parents was 69%. Problems with peer relationships and prosocial behavior were the most affected areas with clinically elevated scores in 22% of the children. Psychosocial difficulties were distributed similarly across types of hearing device, nature and degrees of hearing loss, and educational settings. Better speech perception in quiet was significantly associated with fewer parent-reported conduct problems. CONCLUSION The results of the present study suggest that children with hearing loss may be at risk of experiencing challenges with social interactions and attachment in social contexts. Using the SDQ in clinical follow-up may improve the chances for early psychological assessment and intervention. In addition, the study found that children's mental health may be impacted by their communication abilities.
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Affiliation(s)
- Tjeerd J de Jong
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, PO box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Marc P van der Schroeff
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, PO box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Marieke D Achterkamp
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jantien L Vroegop
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, PO box 2040, 3000 CA, Rotterdam, The Netherlands
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Hardman G, Herman R, Kyle FE, Ebbels S, Morgan G. Identifying Developmental Language Disorder in Deaf Children with Cochlear Implants: A Case Study of Three Children. J Clin Med 2023; 12:5755. [PMID: 37685824 PMCID: PMC10488728 DOI: 10.3390/jcm12175755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/24/2023] [Accepted: 08/01/2023] [Indexed: 09/10/2023] Open
Abstract
(1) Background: While spoken language learning delays are assumed for deaf and hard of hearing (DHH) children after cochlear implant (CI), many catch up with their hearing peers. Some DHH children with CIs, however, show persistent delays in language, despite protective factors being in place. This suggests a developmental language disorder (DLD). However, at present there is little consensus on how to diagnose DLD in DHH children. (2) Methods: Given the lack of consensus in this area, a set of case studies provides an appropriate first step. The goal of this paper is to show the plausibility of a DLD diagnosis, following careful analysis of protective and risk factors. A retrospective case study review was conducted for three children. Their long-term language outcomes up to four years after CI were considered in the context of access to sound, speech sound discrimination, social skills and non-verbal cognition. (3) Results: It was possible to posit DLD in one child who had experienced good access to sound, alongside good speech discrimination abilities and social development, and normal non-verbal cognition, but who presented with severe language learning difficulties. (4) Conclusions: Finding markers for DLD in DHH children is important for diagnosis and intervention. The implications for clinical practice are discussed.
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Affiliation(s)
- Gemma Hardman
- Department of Language and Communication Science, City, University of London, London EC1V 0HB, UK; (G.H.); (R.H.)
| | - Rosalind Herman
- Department of Language and Communication Science, City, University of London, London EC1V 0HB, UK; (G.H.); (R.H.)
| | - Fiona Elizabeth Kyle
- Deafness, Cognition and Language Research Centre (DCAL), University College London, London WC1E 6BT, UK
| | - Susan Ebbels
- Moor House Research and Training Institute, Moor House School & College, Oxted RH8 9AQ, UK;
- Language and Cognition, Psychology and Language, University College London, London WC1E 6BT, UK
| | - Gary Morgan
- Psychology and Education Department, University Oberta Catalunya, 08035 Barcelona, Spain;
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Wiseman KB, McCreery RW, Walker EA. Hearing Thresholds, Speech Recognition, and Audibility as Indicators for Modifying Intervention in Children With Hearing Aids. Ear Hear 2023; 44:787-802. [PMID: 36627755 PMCID: PMC10271969 DOI: 10.1097/aud.0000000000001328] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The purpose of this study was to determine if traditional audiologic measures (e.g., pure-tone average, speech recognition) and audibility-based measures predict risk for spoken language delay in children who are hard of hearing (CHH) who use hearing aids (HAs). Audibility-based measures included the Speech Intelligibility Index (SII), HA use, and auditory dosage, a measure of auditory access that weighs each child's unaided and aided audibility by the average hours of HA use per day. The authors also sought to estimate values of these measures at which CHH would be at greater risk for delayed outcomes compared with a group of children with typical hearing (CTH) matched for age and socioeconomic status, potentially signaling a need to make changes to a child's hearing technology or intervention plan. DESIGN The authors compared spoken language outcomes of 182 CHH and 78 CTH and evaluated relationships between language and audiologic measures (e.g., aided SII) in CHH using generalized additive models. They used these models to identify values associated with falling below CTH (by > 1.5 SDs from the mean) on language assessments, putting CHH at risk for language delay. RESULTS Risk for language delay was associated with aided speech recognition in noise performance (<59% phonemes correct, 95% confidence interval [55%, 62%]), aided Speech Intelligibility Index (SII < 0.61, 95% confidence internal [.53,.68]), and auditory dosage (dosage < 6.0, 95% confidence internal [5.3, 6.7]) in CHH. The level of speech recognition in quiet, unaided pure-tone average, and unaided SII that placed children at risk for language delay could not be determined due to imprecise estimates with broad confidence intervals. CONCLUSIONS Results support using aided SII, aided speech recognition in noise measures, and auditory dosage as tools to facilitate clinical decision-making, such as deciding whether changes to a child's hearing technology are warranted. Values identified in this article can complement other metrics (e.g., unaided hearing thresholds, aided speech recognition testing, language assessment) when considering changes to intervention, such as adding language supports, making HA adjustments, or referring for cochlear implant candidacy evaluation.
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Affiliation(s)
| | | | - Elizabeth A. Walker
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA
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Van Bogaert L, Machart L, Gerber S, Lœvenbruck H, Vilain A. Speech rehabilitation in children with cochlear implants using a multisensory (French Cued Speech) or a hearing-focused (Auditory Verbal Therapy) approach. Front Hum Neurosci 2023; 17:1152516. [PMID: 37250702 PMCID: PMC10219235 DOI: 10.3389/fnhum.2023.1152516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/31/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Early exposure to a rich linguistic environment is essential as soon as the diagnosis of deafness is made. Cochlear implantation (CI) allows children to have access to speech perception in their early years. However, it provides only partial acoustic information, which can lead to difficulties in perceiving some phonetic contrasts. This study investigates the contribution of two spoken speech and language rehabilitation approaches to speech perception in children with CI using a lexicality judgment task from the EULALIES battery. Auditory Verbal Therapy (AVT) is an early intervention program that relies on auditory learning to enhance hearing skills in deaf children with CI. French Cued Speech, also called Cued French (CF), is a multisensory communication tool that disambiguates lip reading by adding a manual gesture. Methods In this study, 124 children aged from 60 to 140 months were included: 90 children with typical hearing skills (TH), 9 deaf children with CI who had participated in an AVT program (AVT), 6 deaf children with CI with high Cued French reading skills (CF+), and 19 deaf children with CI with low Cued French reading skills (CF-). Speech perception was assessed using sensitivity (d') using both the hit and false alarm rates, as defined in signal-detection theory. Results The results show that children with cochlear implants from the CF- and CF+ groups have significantly lower performance compared to children with typical hearing (TH) (p < 0.001 and p = 0.033, respectively). Additionally, children in the AVT group also tended to have lower scores compared to TH children (p = 0.07). However, exposition to AVT and CF seems to improve speech perception. The scores of the children in the AVT and CF+ groups are closer to typical scores than those of children in the CF- group, as evidenced by a distance measure. Discussion Overall, the findings of this study provide evidence for the effectiveness of these two speech and language rehabilitation approaches, and highlight the importance of using a specific approach in addition to a cochlear implant to improve speech perception in children with cochlear implants.
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Affiliation(s)
- Lucie Van Bogaert
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, LPNC, Grenoble, France
- Université Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, France
| | - Laura Machart
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, LPNC, Grenoble, France
- Université Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, France
| | - Silvain Gerber
- Université Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, France
| | - Hélène Lœvenbruck
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, LPNC, Grenoble, France
| | - Anne Vilain
- Université Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, France
| | - Consortium EULALIESCostaMaudGillet-PerretEstelleMacLeodAndrea A. N.MeloniGenevièvePuissantClarisseRoseYvanUniversité Grenoble Alpes, France; CRTLA, Centre Hospitalier Universitaire Grenoble Alpes, France; University of Alberta, Edmonton, Canada; Université Grenoble Alpes, France and Université de Montréal, Montréal, Canada; Université Grenoble Alpes, France; Memorial University, Newfoundland, Canada
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Nittrouer S, Lowenstein JH. Recognition of Sentences With Complex Syntax in Speech Babble by Adolescents With Normal Hearing or Cochlear Implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1110-1135. [PMID: 36758200 PMCID: PMC10205108 DOI: 10.1044/2022_jslhr-22-00407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/17/2022] [Accepted: 11/22/2022] [Indexed: 05/25/2023]
Abstract
PURPOSE General language abilities of children with cochlear implants have been thoroughly investigated, especially at young ages, but far less is known about how well they process language in real-world settings, especially in higher grades. This study addressed this gap in knowledge by examining recognition of sentences with complex syntactic structures in backgrounds of speech babble by adolescents with cochlear implants, and peers with normal hearing. DESIGN Two experiments were conducted. First, new materials were developed using young adults with normal hearing as the normative sample, creating a corpus of sentences with controlled, but complex syntactic structures presented in three kinds of babble that varied in voice gender and number of talkers. Second, recognition by adolescents with normal hearing or cochlear implants was examined for these new materials and for sentence materials used with these adolescents at younger ages. Analyses addressed three objectives: (1) to assess the stability of speech recognition across a multiyear age range, (2) to evaluate speech recognition of sentences with complex syntax in babble, and (3) to explore how bottom-up and top-down mechanisms account for performance under these conditions. RESULTS Results showed: (1) Recognition was stable across the ages of 10-14 years for both groups. (2) Adolescents with normal hearing performed similarly to young adults with normal hearing, showing effects of syntactic complexity and background babble; adolescents with cochlear implants showed poorer recognition overall, and diminished effects of both factors. (3) Top-down language and working memory primarily explained recognition for adolescents with normal hearing, but the bottom-up process of perceptual organization primarily explained recognition for adolescents with cochlear implants. CONCLUSIONS Comprehension of language in real-world settings relies on different mechanisms for adolescents with cochlear implants than for adolescents with normal hearing. A novel finding was that perceptual organization is a critical factor. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21965228.
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Affiliation(s)
- Susan Nittrouer
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
| | - Joanna H. Lowenstein
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
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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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Boonen N, Kloots H, Nurzia P, Gillis S. Spontaneous speech intelligibility: early cochlear implanted children versus their normally hearing peers at seven years of age. JOURNAL OF CHILD LANGUAGE 2023; 50:78-103. [PMID: 36503545 DOI: 10.1017/s0305000921000714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Speaking intelligibly is an important achievement in children's language development. How far do congenitally severe-to-profound hearing-impaired children who received a cochlear implant (CI) in the first two years of their life advance on the path to intelligibility in comparison to children with typical hearing (NH)? Spontaneous speech samples of children with CI and children with NH were orthographically transcribed by naïve transcribers. The entropy of the transcriptions was computed to analyze their degree of uniformity. The same samples were also rated on a continuous rating scale by another group of adult listeners. The transcriptions of the NH children's speech were more uniform, i.e., had significantly lower entropy, than those of the CI children, suggesting that the latter group displayed lower intelligibility. This was confirmed by the ratings on the continuous scale. Despite the relatively restricted age ranges, older children reached better intelligibility scores in both groups.
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Affiliation(s)
- Nathalie Boonen
- Computational Linguistics, & Psycholinguistics Research Centre, University of Antwerp, Antwerp, Belgium E-mail:
| | - Hanne Kloots
- Computational Linguistics, & Psycholinguistics Research Centre, University of Antwerp, Antwerp, Belgium E-mail:
| | - Pietro Nurzia
- Computational Linguistics, & Psycholinguistics Research Centre, University of Antwerp, Antwerp, Belgium E-mail:
| | - Steven Gillis
- Computational Linguistics, & Psycholinguistics Research Centre, University of Antwerp, Antwerp, Belgium E-mail:
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17
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Silva VAR, Pauna HF, Lavinsky J, Hyppolito MA, Vianna MF, Leal M, Massuda ET, Hamerschmidt R, Bahmad Jr F, Cal RV, Sampaio ALL, Felix F, Chone CT, Castilho AM. Task force Guideline of Brazilian Society of Otology - hearing loss in children - Part II - Treatment. Braz J Otorhinolaryngol 2022; 89:190-206. [PMID: 36528468 PMCID: PMC9874354 DOI: 10.1016/j.bjorl.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To provide an overview of the main evidence-based recommendations for the diagnosis of hearing loss in children and adolescents aged 0-18 years. METHODS Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on childhood hearing loss were eligible for inclusion. The American College of Physicians' guideline grading system and the American Thyroid Association's guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. RESULTS The topics were divided into 2 parts: (1) treatment of sensorineural hearing loss: individual hearing aids, bilateral cochlear implants, cochlear implants in young children, unilateral hearing loss, and auditory neuropathy spectrum disorder; and (2) treatment of conductive/mixed hearing loss: external/middle ear malformations, ventilation tube insertion, and tympanoplasty in children. CONCLUSIONS In children with hearing loss, in addition to speech therapy, Hearing AIDS (HAs) or implantable systems may be indicated. Even in children with profound hearing loss, both the use of HAs and behavioral assessments while using the device are important.
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Affiliation(s)
- Vagner Antonio Rodrigues Silva
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil,Corresponding author.
| | - Henrique Furlan Pauna
- Hospital Universitário Cajuru, Departamento de Otorrinolaringologia, Curitiba, PR, Brazil
| | - Joel Lavinsky
- Universidade Federal do Rio Grande do Sul (UFRGS), Departamento de Cirurgia, Porto Alegre, RS, Brazil
| | - Miguel Angelo Hyppolito
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Melissa Ferreira Vianna
- Irmandade Santa Casa de Misericórdia de São Paulo, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Mariana Leal
- Universidade Federal de Pernambuco (UFPE), Departamento de Cirurgia, Recife, PE, Brazil
| | - Eduardo Tanaka Massuda
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Rogério Hamerschmidt
- Universidade Federal do Paraná (UFPR), Hospital de Clínicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Curitiba, PR, Brazil
| | - Fayez Bahmad Jr
- Universidade de Brasília (UnB), Programa de Pós-Graduação em Ciências da Saúde, Brasília, DF, Brazil,Instituto Brasiliense de Otorrinolaringologia (IBO), Brasília, DF, Brazil
| | - Renato Valério Cal
- Centro Universitário do Estado do Pará (CESUPA), Departamento de Otorrinolaringologia, Belém, PA, Brazil
| | - André Luiz Lopes Sampaio
- Universidade de Brasília (UnB), Faculdade de Medicina, Laboratório de Ensino e Pesquisa em Otorrinolaringologia, Brasília, DF, Brazil
| | - Felippe Felix
- Universidade Federal do Rio de Janeiro (UFRJ), Hospital Universitário Clementino Fraga Filho (HUCFF), Departamento de Otorrinolaringologia, Rio de Janeiro, RJ, Brazil
| | - Carlos Takahiro Chone
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Arthur Menino Castilho
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
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Hardman G, Kyle F, Herman R, Morgan G. Pre-linguistic social communication skills and post implant language outcomes in deaf children with cochlear implants. JOURNAL OF COMMUNICATION DISORDERS 2022; 100:106275. [PMID: 36327573 DOI: 10.1016/j.jcomdis.2022.106275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/12/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE This study investigates the relationship between pre-linguistic social communication skills and age of cochlear implant for future language outcomes in a large sample of deaf children. METHOD A retrospective cohort study of records from 75 children. Pre-implant data included Age at Implant, pre-linguistic communication (social, symbolic and speech) skills, and non-verbal ability. Receptive and expressive language development data at 1 year, 2 years and 4 years post implant were analysed to investigate the relationships between pre-implant factors and language outcomes, in particular pre-linguistic social communication skills in early and late implanted children. RESULTS Age at Implant was the strongest correlate of post implant expressive and receptive language outcomes. The sample was divided into early implanted (<18 month) and late implanted (>18 months) children. In the early implanted group, pre-linguistic social communication skills were the strongest pre-implant correlate of language outcomes four years post-implant. In the late implanted group, there were no significant pre-implant correlates of language outcomes. CONCLUSIONS Long term language outcomes after cochlear implantation are the product of a set of communicative, cognitive and environmental factors. Early pre-implant social communication skills are an important consideration for clinicians who guide parents as to likely long-term outcomes post cochlear implantation. Social communication skills are particularly important for children who receive implants before the age of 18 months.
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Affiliation(s)
| | | | | | - Gary Morgan
- City, University of London, UK; Universitat Oberta de Catalunya.
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19
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Speech Accuracy and Reading in Children with Cochlear Implants. PSYCHOLOGICAL RECORD 2022. [DOI: 10.1007/s40732-022-00518-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lund E, Werfel KL. The Effects of Virtual Assessment on Capturing Skill Growth in Children With Hearing Loss. Lang Speech Hear Serv Sch 2022; 53:391-403. [PMID: 35167342 DOI: 10.1044/2021_lshss-21-00074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study is to evaluate the effects of switching from in-person assessment to virtual assessment during the COVID-19 pandemic on the growth trajectories of children with hearing loss who are learning spoken language. METHOD Sixty-eight children with typical hearing, 44 children with cochlear implants, and 47 children with hearing aids were assessed with a norm-referenced measure of receptive vocabulary, a criterion-referenced measure of phonological awareness, and a criterion-referenced measure of conceptual print knowledge at least 4 times, at 6-month intervals, between the ages of 4 and 6 years. Of those participants, 26 children with typical hearing, 13 children with cochlear implants, and 13 children with hearing aids entered virtual testing as a result of the COVID-19 pandemic. The slopes of growth for children who entered virtual testing were compared to their own slopes prepandemic and to the growth slopes of children who completed all testing in-person, prepandemic. RESULTS Within-subject comparisons across all measures did not show a change in growth slopes prepandemic to postpandemic. For the measure of conceptual print knowledge, children who were tested during the pandemic showed slower overall growth than children who were tested prepandemic. No effects of hearing status were found across growth on any measure. CONCLUSION These preliminary data support the use of virtual assessment to measure growth in receptive vocabulary, phonological awareness, and conceptual print knowledge in children with hearing loss learning spoken language.
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Affiliation(s)
- Emily Lund
- Davies School of Communication Sciences & Disorders, Texas Christian University, Fort Worth
| | - Krystal L Werfel
- Center for Deafness, Language, and Learning, Boys Town National Research Hospital, Omaha, NE
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21
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Xu L, Luo J, Wang M, Xie D, Chao X, Li J, Liu X, He S, Spencer L, Guo LY. Vocabulary Growth in Mandarin-Speaking Children With Bilateral Cochlear Implants, Bimodal Stimulation, or Unilateral Cochlear Implants During the First Year After Activation. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1630-1645. [PMID: 35302899 DOI: 10.1044/2021_jslhr-21-00454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The purpose of this study was to evaluate vocabulary development in Mandarin-speaking children with bilateral cochlear implants (CIs), bimodal stimulation (CI plus hearing aids [HAs]), or unilateral CIs during the first year after CI activation. METHOD Participants included 23 children with simultaneous bilateral CIs, 23 children with bimodal stimulation, and 15 children with unilateral CIs. They all received CIs before 30 months of age. Parents were asked to endorse words that their child could understand only or understand and say using the Early Vocabulary Inventory for Mandarin Chinese at the day of CI activation and 1, 3, 6, 9, and 12 months after CI activation. Receptive and expressive vocabulary sizes were computed. RESULTS Growth curve analysis revealed that children with simultaneous bilateral CIs demonstrated faster growth of receptive vocabulary than those with bimodal stimulation, followed by those with unilateral CIs. Moreover, children with simultaneous bilateral CIs reached the 100-word mark for receptive vocabulary earlier than children with bimodal stimulation, followed by those with unilateral CIs. There were no significant differences among the three groups in expressive vocabulary. CONCLUSIONS Bilateral CIs have an advantage over bimodal stimulation in early receptive vocabulary development in Mandarin, a tone language. HA usage is still recommended for those who receive one CI.
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Affiliation(s)
- Lei Xu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Jianfen Luo
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Min Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Dianzhao Xie
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Xiuhua Chao
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Jinming Li
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Xianqi Liu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Auditory Implantation, Shandong Provincial ENT Hospital, Jinan, China
| | - Shuman He
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus
- Department of Audiology, Nationwide Children's Hospital, Columbus, OH
| | - Linda Spencer
- MSSLP Program, Rocky Mountain University of Health Professions, Provo, UT
| | - Ling-Yu Guo
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan
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Bálint A, Wimmer W, Caversaccio M, Weder S. Neural Activity during Audiovisual Speech Processing: Protocol for a Functional Neuroimaging Study (Preprint). JMIR Res Protoc 2022; 11:e38407. [PMID: 35727624 PMCID: PMC9239541 DOI: 10.2196/38407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/12/2022] [Accepted: 06/03/2022] [Indexed: 11/21/2022] Open
Abstract
Background Functional near-infrared spectroscopy (fNIRS) studies have demonstrated associations between hearing outcomes after cochlear implantation and plastic brain changes. However, inconsistent results make it difficult to draw conclusions. A major problem is that many variables need to be controlled. To gain further understanding, a careful preparation and planning of such a functional neuroimaging task is key. Objective Using fNIRS, our main objective is to develop a well-controlled audiovisual speech comprehension task to study brain activation in individuals with normal hearing and hearing impairment (including cochlear implant users). The task should be deductible from clinically established tests, induce maximal cortical activation, use optimal coverage of relevant brain regions, and be reproducible by other research groups. Methods The protocol will consist of a 5-minute resting state and 2 stimulation periods that are 12 minutes each. During the stimulation periods, 13-second video recordings of the clinically established Oldenburg Sentence Test (OLSA) will be presented. Stimuli will be presented in 4 different modalities: (1) speech in quiet, (2) speech in noise, (3) visual only (ie, lipreading), and (4) audiovisual speech. Each stimulus type will be repeated 10 times in a counterbalanced block design. Interactive question windows will monitor speech comprehension during the task. After the measurement, we will perform a 3D scan to digitize optode positions and verify the covered anatomical locations. Results This paper reports the study protocol. Enrollment for the study started in August 2021. We expect to publish our first results by the end of 2022. Conclusions The proposed audiovisual speech comprehension task will help elucidate neural correlates to speech understanding. The comprehensive study will have the potential to provide additional information beyond the conventional clinical standards about the underlying plastic brain changes of a hearing-impaired person. It will facilitate more precise indication criteria for cochlear implantation and better planning of rehabilitation. International Registered Report Identifier (IRRID) DERR1-10.2196/38407
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Affiliation(s)
- András Bálint
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Hearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Wilhelm Wimmer
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Hearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Marco Caversaccio
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Hearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Stefan Weder
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Hearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
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23
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Breland L, Lowenstein JH, Nittrouer S. Disparate Oral and Written Language Abilities in Adolescents With Cochlear Implants: Evidence From Narrative Samples. Lang Speech Hear Serv Sch 2022; 53:193-212. [PMID: 34898258 DOI: 10.1044/2021_lshss-21-00062] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE In spite of improvements in language outcomes for children with hearing loss (HL) arising from cochlear implants (CIs), these children can falter when it comes to academic achievement, especially in higher grades. Given that writing becomes increasingly relevant to educational pursuits as children progress through school, this study explored the hypothesis that one challenge facing students with CIs may be written language. METHOD Participants were 98 eighth graders: 52 with normal hearing (NH) and 46 with severe-to-profound HL who used CIs. Oral and written narratives were elicited and analyzed for morphosyntactic complexity and global narrative features. Five additional measures were collected and analyzed as possible predictors of morphosyntactic complexity: Sentence Comprehension of Syntax, Grammaticality Judgment, Expressive Vocabulary, Forward Digit Span, and Phonological Awareness. RESULTS For oral narratives, groups performed similarly on both morphosyntactic complexity and global narrative features; for written narratives, critical differences were observed. Compared with adolescents with NH, adolescents with CIs used fewer markers of morphosyntactic complexity and scored lower on several global narrative features in their written narratives. Adolescents with NH outperformed those with CIs on all potential predictor measures, except for Sentence Comprehension of Syntax. Moderately strong relationships were found between predictor variables and individual measures of morphosyntactic complexity, but no comprehensive pattern explained the results. Measures of morphosyntactic complexity and global narrative features were not well correlated, suggesting these measures are assessing separate underlying constructs. CONCLUSIONS Adolescents with CIs fail to show writing proficiency at high school entry equivalent to that of their peers with NH, which could constrain their academic achievement. Interventions for children with CIs need to target writing skills, and writing assessments should be incorporated into diagnostic assessments. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.17139059.
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Affiliation(s)
- Luke Breland
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
| | - Joanna H Lowenstein
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
| | - Susan Nittrouer
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
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Phonological Priming as a Lens for Phonological Organization in Children With Cochlear Implants. Ear Hear 2022; 43:1355-1365. [PMID: 34923557 PMCID: PMC9203598 DOI: 10.1097/aud.0000000000001191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To evaluate the subconscious knowledge of between-word phonological similarities in children with cochlear implants as compared with children with typical hearing. DESIGN Participants included 30 children with cochlear implants between the ages of five and seven who used primarily spoken English to communicate, 30 children matched for chronological age, and 30 children matched for vocabulary size. Participants completed an animacy judgment task in either a (a) neutral condition, (b) a phonological prime condition where the consonant and vowel onset of the pictured word was presented prior to the visual target's appearance, (c) an inhibition prime condition where a consonant and vowel onset not matching the pictured word was presented prior to the target's appearance. Reaction times were recorded. RESULTS Children with cochlear implants reacted differently and more slowly than children with typical hearing in both groups to the primes: children with typical hearing experienced a phonological facilitation effect in the phonological prime condition, whereas children with cochlear implants did not. Children with cochlear implants also had reaction times that, overall, were slower than children matched for chronological age but similar to children matched for vocabulary size. CONCLUSIONS The different experience of children with cochlear implants with phonological facilitation and inhibition effects may indicate children with cochlear implants have phonological organization strategies that are different from those of children with typical hearing.
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Lund E, Brock N, Werfel KL. Location Effects on Spoken Language and Literacy for Children who are DHH. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2021; 27:48-61. [PMID: 34586385 PMCID: PMC8682316 DOI: 10.1093/deafed/enab030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 06/13/2023]
Abstract
The purpose of this study was to consider how living in an area that qualifies for a rural health grant interacts with a child's hearing status to affect early language and literacy development. Four-year-old children with hearing aids (n = 45), cochlear implants (n = 47), and with typical hearing (n = 66) completed measures of spoken language knowledge and of emergent literacy skills as part of a larger longitudinal investigation. A significant interaction effect between location (rural or urban/suburban) and amplification group was detected for letter knowledge: children with hearing aids exhibit a performance that is particularly affected by rural location. Overall, children with cochlear implants performed lower across all measures than children with typical hearing, and children with hearing aids performed lower than children with typical hearing on measures of phonological awareness, vocabulary, omnibus language knowledge and articulation.
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Affiliation(s)
- Emily Lund
- Davies School of Communication Sciences and Disorders, Texas Christian University, Fort Worth, TX, USA
| | - Nicholas Brock
- Davies School of Communication Sciences and Disorders, Texas Christian University, Fort Worth, TX, USA
| | - Krystal L Werfel
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
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David C, Tuller L, Schweitzer E, Lescanne E, Bonnet-Brilhault F, Gomot M, Ferré S. Does Phonological Complexity Provide a Good Index of Language Disorder in Children With Cochlear Implants? JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4271-4286. [PMID: 34726957 DOI: 10.1044/2021_jslhr-20-00642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose Phonological complexity is known to be a good index of developmental language disorder (DLD) in normal-hearing children, who have major difficulties on some complex structures. Some deaf children with cochlear implants (CIs) present a profile that evokes DLD, with persistent linguistic difficulties despite good audiological and environmental conditions. However, teasing apart what is related to auditory deficit or to language disorder remains complex. Method We compared the performance of three groups of school-age children, 33 children with CI, 22 with DLD, and 24 with typical development, on a nonword repetition (NWR) task based on phonological complexity. Children with CI were studied regarding their linguistic profile, categorized in four subgroups ranging from excellent to very poor performance. Influence of syllable length and phonological structures on the results of all the children were explored. Results The NWR task correctly distinguished children with DLD from typically developing children, and also children with CI with the poorest linguistic performance from other children with CI. However, most complex phonological structures did not reliably identify children with CI displaying a profile similar to that of children with DLD because these structures were difficult for all of the children with CI. The simplest phonological structures were better at detecting persistent language difficulties in children with CI, as they were challenging only for the children with the poorest language outcomes. Conclusions The most complex phonological structures are not good indices of language disorder in children with CI. Phonological complexity represents a gradient of difficulty that affects normal-hearing and deaf children differently.
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Affiliation(s)
- Céline David
- UMR 1253, iBrain, Université de Tours, Inserm, France
| | | | | | | | - Frédérique Bonnet-Brilhault
- UMR 1253, iBrain, Université de Tours, Inserm, France
- Centre Universitaire de Pédopsychiatrie, CHRU de Tours, France
| | - Marie Gomot
- UMR 1253, iBrain, Université de Tours, Inserm, France
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Harrison SC, Lawrence R, Hoare DJ, Wiggins IM, Hartley DEH. Use of Functional Near-Infrared Spectroscopy to Predict and Measure Cochlear Implant Outcomes: A Scoping Review. Brain Sci 2021; 11:brainsci11111439. [PMID: 34827438 PMCID: PMC8615917 DOI: 10.3390/brainsci11111439] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/15/2021] [Accepted: 10/25/2021] [Indexed: 11/21/2022] Open
Abstract
Outcomes following cochlear implantation vary widely for both adults and children, and behavioral tests are currently relied upon to assess this. However, these behavioral tests rely on subjective judgements that can be unreliable, particularly for infants and young children. The addition of an objective test of outcome following cochlear implantation is therefore desirable. The aim of this scoping review was to comprehensively catalogue the evidence for the potential of functional near infrared spectroscopy (fNIRS) to be used as a tool to objectively predict and measure cochlear implant outcomes. A scoping review of the literature was conducted following the PRISMA extension for scoping review framework. Searches were conducted in the MEDLINE, EMBASE, PubMed, CINAHL, SCOPUS, and Web of Science electronic databases, with a hand search conducted in Google Scholar. Key terms relating to near infrared spectroscopy and cochlear implants were used to identify relevant publications. Eight records met the criteria for inclusion. Seven records reported on adult populations, with five records only including post-lingually deaf individuals and two including both pre- and post-lingually deaf individuals. Studies were either longitudinal or cross-sectional, and all studies compared fNIRS measurements with receptive speech outcomes. This review identified and collated key work in this field. The homogeneity of the populations studied so far identifies key gaps for future research, including the use of fNIRS in infants. By mapping the literature on this important topic, this review contributes knowledge towards the improvement of outcomes following cochlear implantation.
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Affiliation(s)
- Samantha C. Harrison
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK; (R.L.); (D.J.H.); (I.M.W.); (D.E.H.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG1 5DU, UK
- Correspondence: ; Tel.: +44-115-823-2640
| | - Rachael Lawrence
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK; (R.L.); (D.J.H.); (I.M.W.); (D.E.H.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG1 5DU, UK
- Nottingham University Hospitals National Health Service Trust, Nottingham NG5 1PB, UK
| | - Derek J. Hoare
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK; (R.L.); (D.J.H.); (I.M.W.); (D.E.H.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG1 5DU, UK
| | - Ian M. Wiggins
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK; (R.L.); (D.J.H.); (I.M.W.); (D.E.H.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG1 5DU, UK
| | - Douglas E. H. Hartley
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK; (R.L.); (D.J.H.); (I.M.W.); (D.E.H.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG1 5DU, UK
- Nottingham University Hospitals National Health Service Trust, Nottingham NG5 1PB, UK
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Arjmandi M, Houston D, Wang Y, Dilley L. Estimating the reduced benefit of infant-directed speech in cochlear implant-related speech processing. Neurosci Res 2021; 171:49-61. [PMID: 33484749 PMCID: PMC8289972 DOI: 10.1016/j.neures.2021.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/19/2020] [Accepted: 01/17/2021] [Indexed: 11/27/2022]
Abstract
Caregivers modify their speech when talking to infants, a specific type of speech known as infant-directed speech (IDS). This speaking style facilitates language learning compared to adult-directed speech (ADS) in infants with normal hearing (NH). While infants with NH and those with cochlear implants (CIs) prefer listening to IDS over ADS, it is yet unknown how CI processing may affect the acoustic distinctiveness between ADS and IDS, as well as the degree of intelligibility of these. This study analyzed speech of seven female adult talkers to model the effects of simulated CI processing on (1) acoustic distinctiveness between ADS and IDS, (2) estimates of intelligibility of caregivers' speech in ADS and IDS, and (3) individual differences in caregivers' ADS-to-IDS modification and estimated speech intelligibility. Results suggest that CI processing is substantially detrimental to the acoustic distinctiveness between ADS and IDS, as well as to the intelligibility benefit derived from ADS-to-IDS modifications. Moreover, the observed variability across individual talkers in acoustic implementation of ADS-to-IDS modification and the estimated speech intelligibility was significantly reduced due to CI processing. The findings are discussed in the context of the link between IDS and language learning in infants with CIs.
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Affiliation(s)
- Meisam Arjmandi
- Department of Communicative Sciences and Disorders, Michigan State University, 1026 Red Cedar Road, East Lansing, MI 48824, USA.
| | - Derek Houston
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University, 915 Olentangy River Road, Columbus, OH 43212, USA
| | - Yuanyuan Wang
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University, 915 Olentangy River Road, Columbus, OH 43212, USA
| | - Laura Dilley
- Department of Communicative Sciences and Disorders, Michigan State University, 1026 Red Cedar Road, East Lansing, MI 48824, USA
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Šikolová S, Urík M, Hošnová D, Kruntorád V, Bartoš M, Motyka O, Jabandžiev P. Two Bonebridge bone conduction hearing implant generations: audiological benefit and quality of hearing in children. Eur Arch Otorhinolaryngol 2021; 279:3387-3398. [PMID: 34495351 PMCID: PMC9130159 DOI: 10.1007/s00405-021-07068-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/31/2021] [Indexed: 12/05/2022]
Abstract
Purpose The study aimed to evaluate audiological benefits, quality of hearing and safety of two Bonebridge generation: BCI601 and BCI602 (MED-EL, Innsbruck, Austria) in children. Methods Twelve children were implanted: five BCI601 and seven BCI602 comprising of ten conductive hearing loss, and two single sided deaf SSD subjects. Audiological outcomes tested were sound field audiometry, functional gain, speech recognition threshold (SRT50), speech recognition in noise (SPRINT) and localisation abilities. Subjective measures were Speech, Spatial and Qualities of Hearing Scale (SSQ12). Results The mean FG with the BCI601 was 25.0 dB and with the BCI602 28.0 dB. The benefit in SRT50 was 23.2 dB and 33.8 dB, respectively. The mean benefit in SPRINT was 15% and 6.7% and the localisation ability improved from 33.3° to 16° and from 26.2° to 17.6°, respectively. The two SSD subjects reported a FG of 17 dB, a benefit in SRT50 of 22.5 and a benefit in SPRINT of 20%. Subjective outcomes improved significantly and even exceeded the values of their age-and sex matched normal hearing peers. One revision was reported: a retroauricular emphysema above the implant occurred 12 months post-OP, it was resolved operatively with the implant still being functional. Conclusion The pediatric cohort reports significant audiological benefit, even exceeding that of the age- and sex matched control. The combination of the high safety and audiological benefit makes the Bonebridge a comfortable and effective option in hearing rehabilitation in children.
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Affiliation(s)
- 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
| | - 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.
| | - 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
| | - Oldřich Motyka
- Nanotechnology Centre, CEET, VSB-Technical University of Ostrava, 708 00, Ostrava-Poruba, Czech Republic.,Centre ENET, CEET, VSB-Technical University of Ostrava, 708 00, Ostrava-Poruba, 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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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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Werfel KL, Bassard SD, Squires C. Nonverbal Intelligence Predicts Performance of Preschool Children With Hearing Loss on Norm-Referenced Language Measures But Not Language Sample Analysis. Ear Hear 2021; 41:1764-1771. [PMID: 33136649 PMCID: PMC8611815 DOI: 10.1097/aud.0000000000000897] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose of this study was to explore the effects of nonverbal intelligence on spoken language performance in children with hearing loss who use amplification and spoken language. Specifically, we compared language performance measured by norm-referenced measures compared with spontaneous language sample measures. DESIGN Nonverbal intelligence and spoken language skills were analyzed using norm-referenced nonverbal intelligence and language assessments and language sample analyses in 92 children ages 3 to 6 who varied by hearing and nonverbal intelligence status. All children had nonverbal intelligence within the average or above-average range. RESULTS Regression analyses revealed that, after controlling for maternal education and hearing status, nonverbal intelligence contributed unique variance to norm-referenced language measures but not spontaneous language measures. CONCLUSIONS Performance on norm-referenced language measures is influenced by nonverbal intelligence, whereas functional language use measured by spontaneous language samples is not. These findings suggest that spontaneous language measures may contribute additional value to language assessment batteries that are independent of nonverbal intelligence.
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Affiliation(s)
- Krystal L Werfel
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, South Carolina, USA
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Sahlén B, Ibertsson T, Asker-Árnason L, Brännström J, Hansson K. Best ear hearing level, time factors and language outcome in Swedish children with mild and moderate hearing loss with hearing aids. LOGOP PHONIATR VOCO 2021; 47:239-248. [PMID: 34287105 DOI: 10.1080/14015439.2021.1951347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM The risk for language disorder is high in children with all levels of hearing loss (HL). Early identification and intervention should be as important for children with mild HL as for those with more severe HL. Despite new-born hearing screening, a recent survey of speech language therapist services in southern Sweden indicates that children with mild and moderate HL are severely neglected when it comes to language assessment and language intervention. In this study we explore associations between Best Ear Hearing Level (BEHL), time factors and language skills in Swedish children with HL with hearing aids (HA). METHOD Participants were 19 children with mild HL (BEHL 23-39) and 22 children with moderate HL (BEHL 40-70) aged 5-15 years. Information on age at diagnosis and at HA fitting were collected. The children performed a nonword repetition and a sentence comprehension task. RESULTS The time elapsed between diagnosis and fitting with HA was longer for the children with mild HL.Participants with mild HL received their HA significantly later than children with moderate HL. No association between BEHL and the two language measures was found, and language skills were not better in children with mild than moderate HL. 17% of participants performed below cut-off for language disorder on both language measures. CONCLUSION Given the risk for long-term academic and social consequences of even mild HL delayed HA intervention for children with HLleads to serious concerns by families, clinicians, and pedagogues.
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Affiliation(s)
- Birgitta Sahlén
- Department of Clinical Sciences, Lund, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Tina Ibertsson
- Department of Clinical Sciences, Lund, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Lena Asker-Árnason
- Department of Clinical Sciences, Lund, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Jonas Brännström
- Department of Clinical Sciences, Lund, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Kristina Hansson
- Department of Clinical Sciences, Lund, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
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Spoken Language Skills in Children With Bilateral Hearing Aids or Bilateral Cochlear Implants at the Age of Three Years. Ear Hear 2021; 43:220-233. [PMID: 34260435 PMCID: PMC8694252 DOI: 10.1097/aud.0000000000001092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Early hearing aid (HA) fitting and cochlear implants (CIs) aim to reduce the effects of hearing loss (HL) on spoken language development. The goals of this study were (1) to examine spoken language skills of children with bilateral HAs and children with bilateral CIs; (2) to compare their language skills to the age-norms of peers with normal hearing (NH); and (3) to investigate factors associated with spoken language outcomes.
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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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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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Glaubitz C, Liebscher T, Hoppe U. [Impact of CI use and CI fitting on speech production in very early cochlear-implanted infants]. HNO 2021; 69:425-434. [PMID: 32930827 PMCID: PMC8076147 DOI: 10.1007/s00106-020-00942-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Children's age at implantation is an important factor for their outcome in auditory and language skills with a cochlear implant (CI). CI use and frequency of CI fitting may also influence speech performance. Purpose of this study was to evaluate CI use and CI fitting of very early implanted infants and its potential influence on age-related speech production performance. METHODS Data of 34 bilaterally cochlea-implanted infants (age at CI in months: M = 8,8; SD = 1,7) were included. During the third year of life speech production performance was evaluated and related to datalogging-based CI use and number of CI fitting sessions. RESULTS About half of the cohort achieved speech production level within the normal range of hearing peers. Daily time of CI use was approximately 8 h. Analysis of listening environment showed that infants were exposed most of the time to quiet environment and least amount of time to speech in noise. Daily time of CI use seems to be a significant predictor of speech production, speech-exposition particularly predicts word production. Number of daily disconnection between CI-processor and implant as well as the monthly number of CI fitting sessions were not correlated with speech production. CONCLUSION Very early cochlear implanted infants may achieve age-appropriate speech production performance in the third year of life. Time of daily CI use in the study cohort is comparable to results of other studies. Time of daily CI use and exposure to speech seem to be important factors for early speech production. These findings should be integrated in pre- and postoperative parent counselling.
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Affiliation(s)
- C Glaubitz
- Hals-Nasen-Ohrenklinik, Kopf- und Halschirurgie, Cochlear-Implant-Centrum CICERO, Universitätsklinikum Erlangen, Waldstr. 1, 91054, Erlangen, Deutschland.
| | - T Liebscher
- Hals-Nasen-Ohrenklinik, Kopf- und Halschirurgie, Cochlear-Implant-Centrum CICERO, Universitätsklinikum Erlangen, Waldstr. 1, 91054, Erlangen, Deutschland
| | - U Hoppe
- Hals-Nasen-Ohrenklinik, Kopf- und Halschirurgie, Cochlear-Implant-Centrum CICERO, Universitätsklinikum Erlangen, Waldstr. 1, 91054, Erlangen, Deutschland
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Gordon KA, Daien MF, Negandhi J, Blakeman A, Ganek H, Papsin B, Cushing SL. Exposure to Spoken Communication in Children With Cochlear Implants During the COVID-19 Lockdown. JAMA Otolaryngol Head Neck Surg 2021; 147:368-376. [PMID: 33599710 DOI: 10.1001/jamaoto.2020.5496] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance The coronavirus disease 2019 (COVID-19) lockdowns in Ontario, Canada in the spring of 2020 created unprecedented changes in the lives of all children, including children with hearing loss. Objective To quantify how these lockdowns changed the spoken communication environments of children with cochlear implants by comparing the sounds they were exposed to before the Ontario provincial state of emergency in March 2020 and during the resulting closures of schools and nonessential businesses. Design, Setting, and Participants This experimental cohort study comprised children with hearing loss who used cochlear implants to hear. These children were chosen because (1) their devices monitor and catalog levels and types of sounds during hourly use per day (datalogs), and (2) this group is particularly vulnerable to reduced sound exposure. Children were recruited from the Cochlear Implant Program at a tertiary pediatric hospital in Ontario, Canada. Children whose cochlear implant datalogs were captured between February 1 and March 16, 2020, shortly before lockdown (pre-COVID-19), were identified. Repeated measures were collected in 45 children during initial easing of lockdown restrictions (stages 1-2 of the provincial recovery plan); resulting datalogs encompassed the lockdown period (peri-COVID-19). Main Outcomes and Measures Hours of sound captured by the Cochlear Nucleus datalogging system (Cochlear Corporation) in 6 categories of input levels (<40, 40-49, 50-59, 60-69, 70-79, ≥80 A-weighted dB sound pressure levels [dBA]) and 6 auditory scene categories (quiet, speech, speech-in-noise, music, noise, and other). Mixed-model regression analyses revealed main effects with post hoc adjustment of confidence intervals using the Satterthwaite method. Results A total of 45 children (mean [SD] age, 7.7 [5.0] years; 23 girls [51.1%]) participated in this cohort study. Results showed similar daily use of cochlear implants during the pre- and peri-COVID-19 periods (9.80 mean hours pre-COVID-19 and 9.34 mean hours peri-COVID-19). Despite consistent device use, these children experienced significant quieting of input sound levels peri-COVID-19 by 0.49 hour (95% CI, 0.21-0.80 hour) at 60 to 69 dBA and 1.70 hours (95% CI, 1.42-1.99 hours) at 70 to 79 dBA with clear reductions in speech exposure by 0.98 hour (95% CI, 0.49-1.47 hours). This outcome translated into a reduction of speech:quiet from 1.6:1.0 pre-COVID-19 to 0.9:1.0 during lockdowns. The greatest reductions in percentage of daily speech occurred in school-aged children (elementary, 12.32% [95% CI, 7.15%-17.49%]; middle school, 11.76% [95% CI, 5.00%-18.52%]; and high school, 9.60% [95% CI, 3.27%-15.93%]). Increased daily percentage of quiet (7.00% [95% CI, 4.27%-9.74%]) was most prevalent for children who had fewer numbers of people in their household (estimate [SE] = -1.12% [0.50%] per person; Cohen f = 0.31). Conclusions and Relevance The findings of this cohort study indicate a clear association of COVID-19 lockdowns with a reduction in children's access to spoken communication.
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Affiliation(s)
- Karen A Gordon
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Communication Disorders, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Maya F Daien
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jaina Negandhi
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alan Blakeman
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Hillary Ganek
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Blake Papsin
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sharon L Cushing
- Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.,Department of Otolaryngology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Werfel KL, Reynolds G, Hudgins S, Castaldo M, Lund EA. The Production of Complex Syntax in Spontaneous Language by 4-Year-Old Children With Hearing Loss. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:609-621. [PMID: 33647212 PMCID: PMC8740732 DOI: 10.1044/2020_ajslp-20-00178] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/03/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
Purpose Proficiency with complex syntax is important for language and reading comprehension, and production of complex syntax begins to emerge shortly after a young child begins using two-word combinations. Complex syntax production in preschool children with hearing loss who use spoken language has been explored minimally. The purpose of this study was to compare complex syntax production of 4-year-old children with hearing loss to age-matched and language-matched peers with normal hearing. Method Seventy-two children completed a language assessment battery, including a structured language sample. Complex syntax density and number and accuracy of productions of particular types of complex syntax were compared across three groups: 4-year-old children with hearing loss, an age-matched group of children with normal hearing, and an mean length of utterance (MLU)-matched group of children with normal hearing. Results Children with hearing loss had lower complex syntax density and fewer correct productions of coordinated clauses, subordinate clauses, and simple infinitives than their age-matched, but not language-matched, peers. Furthermore, children with hearing loss had lower accuracy than the age-matched group on simple infinitives and lower accuracy than both the age- and MLU-matched groups on full propositional complements and subject relative clauses. Conclusion Children with hearing loss exhibit delays in complex syntax acquisition as compared to their same-age peers and disruptions in development on some complex structures as compared to MLU-matched, younger children. Supplemental Material https://doi.org/10.23641/asha.14080193.
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Affiliation(s)
- Krystal L. Werfel
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| | - Gabriella Reynolds
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| | - Sarah Hudgins
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| | - Marissa Castaldo
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| | - Emily A. Lund
- Davies School of Communication Sciences & Disorders, Texas Christian University, Fort Worth
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Grenner E, van de Weijer J, Johansson V, Sahlén B. Predictors of narrative text quality in students with hearing loss. LOGOP PHONIATR VOCO 2021; 47:157-165. [PMID: 33565897 DOI: 10.1080/14015439.2021.1881613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM Students with hearing loss (HL) often fall behind hearing peers in complex language tasks such as narrative writing. This study explored the effects of school grade, gender, cognitive and linguistic predisposition and audiological factors on narrative text quality in this target group. METHOD Eleven students with HL in Grades 5-6 and 7-8 (age 12-15) who took part in a writing intervention wrote four narrative texts over six months. A trained panel rated text quality. The effects of the students' working memory capacity, language comprehension, reading comprehension, school grade and gender and the intervention were analyzed as a mixed-effects regression model. Audiological factors were considered separately. RESULTS The analysis showed that throughout the period, texts written by female students in Grade 7-8 received the highest text quality ratings, while those written by male students in Grade 7-8 received the lowest ratings. There was no effect of the intervention, or of the linguistic and cognitive measures. The students with the lowest text quality ratings received amplification later than those with high ratings, but HL severity was not associated with text quality. CONCLUSION Hearing loss severity was not a decisive factor in narrative text quality. The intervention which the students took part in is potentially effective, with some adaptation to the special needs of students with HL. The strong gender effects are discussed.
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Affiliation(s)
- Emily Grenner
- Department of Clinical Sciences, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | | | | | - Birgitta Sahlén
- Department of Clinical Sciences, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
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Nittrouer S, Lowenstein JH. When language outgrows them: Comprehension of ambiguous sentences in children with normal hearing and children with hearing loss. Int J Pediatr Otorhinolaryngol 2021; 141:110514. [PMID: 33268011 PMCID: PMC7856288 DOI: 10.1016/j.ijporl.2020.110514] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND In spite of recent gains in language development made by children with hearing loss (HL) as a result of improved auditory prostheses and earlier starts to intervention, these children continue to struggle academically at higher grade levels. We hypothesize that one reason for these incongruent outcomes for language and academics may be that the language demands of school escalate as grade level increases, outstripping the language abilities of children with HL. We tested that hypothesis by examining a higher level skill that is essential for success with academic language, the ability to access multiple interpretations for a sentence. METHOD 122 children participated at the end of middle school: 56 with normal hearing (NH), 15 with moderate HL who used hearing aids (HAs), and 51 with severe-to-profound HL who used cochlear implants (CIs). Children's abilities to provide more than one interpretation for an ambiguous sentence were assessed. These sentences were ambiguous due either to words having multiple meanings or to syntactic structure that could evoke more than one interpretation. Potential predictors of those abilities were evaluated, including expressive vocabulary, comprehension of syntactic structures, grammaticality judgments, forward digit span, and several audiologic factors. RESULTS Children with NH performed best, children with CIs performed poorest, and children with HAs performed intermediately to those groups. Children in all groups achieved higher scores on the multiple meanings than on the syntactic structure items. The variables that were associated with performance varied across groups. Audiologic factors did not explain any variability in performance on the ambiguous sentences task for children with HL. CONCLUSIONS The kind of linguistic flexibility needed to consider more than one interpretation for sentences lacking immediate, real-world context is essential to processing academic language. Children with HL - especially those with severe-to-profound HL who required CIs - showed deficits in this skill, which could contribute to their ongoing academic struggles. Continued language support is needed for these children to allow them to acquire the higher level language skills necessary for success through all of their years in school.
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Affiliation(s)
- Susan Nittrouer
- Department of Speech, Language, and Hearing Sciences, University of Florida, USA.
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Lowenstein JH, Nittrouer S. The Devil in the Details Can Be Hard to Spot: Malapropisms and Children With Hearing Loss. Lang Speech Hear Serv Sch 2021; 52:335-353. [PMID: 33112723 DOI: 10.1044/2020_lshss-20-00033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Better auditory prostheses and earlier interventions have led to remarkable improvements in spoken language abilities for children with hearing loss (HL), but these children often still struggle academically. This study tested a hypothesis for why this may be, proposing that the language of school becomes increasingly disconnected from everyday discourse, requiring greater reliance on bottom-up phonological structure, and children with HL have difficulty recovering that structure from the speech signal. Participants One hundred nineteen fourth graders participated: 48 with normal hearing (NH), 19 with moderate losses who used hearing aids (HAs), and 52 with severe-to-profound losses who used cochlear implants (CIs). Method Three analyses were conducted. #1: Sentences with malapropisms were created, and children's abilities to recognize them were assessed. #2: Factors contributing to those abilities were evaluated, including phonological awareness, phonological processing, vocabulary, verbal working memory, and oral narratives. #3: Teachers' ratings of students' academic competence were obtained, and factors accounting for those ratings were evaluated, including the five listed above, along with word reading and reading comprehension. Results #1: Children with HAs and CIs performed more poorly on malapropism recognition than children with NH, but similarly to each other. #2: All children with HL demonstrated large phonological deficits, but they were especially large for children with CIs. Phonological awareness explained the most variance in malapropism recognition for children with CIs. Vocabulary knowledge explained malapropism recognition for children with NH or HAs, but other factors also contributed. #3: Teachers rated academic competence for children with CIs more poorly than for children with NH or HAs, and variance in those ratings for children with CIs were primarily explained by malapropism scores. Conclusion Children with HL have difficulty recognizing acoustic-phonetic detail in the speech signal, and that constrains their abilities to follow conversations in academic settings, especially if HL is severe enough to require CIs. Supplemental Material https://doi.org/10.23641/asha.13133018.
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Affiliation(s)
- Joanna H Lowenstein
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
| | - Susan Nittrouer
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
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Abstract
IMPORTANCE Hearing loss in children is common and by age 18 years, affects nearly 1 of every 5 children. Without hearing rehabilitation, hearing loss can cause detrimental effects on speech, language, developmental, educational, and cognitive outcomes in children. OBSERVATIONS Consequences of hearing loss in children include worse outcomes in speech, language, education, social functioning, cognitive abilities, and quality of life. Hearing loss can be congenital, delayed onset, or acquired with possible etiologies including congenital infections, genetic causes including syndromic and nonsyndromic etiologies, and trauma, among others. Evaluation of hearing loss must be based on suspected diagnosis, type, laterality and degree of hearing loss, age of onset, and additional variables such as exposure to cranial irradiation. Hearing rehabilitation for children with hearing loss may include use of hearing aids, cochlear implants, bone anchored devices, or use of assistive devices such as frequency modulating systems. CONCLUSIONS AND RELEVANCE Hearing loss in children is common, and there has been substantial progress in diagnosis and management of these cases. Early identification of hearing loss and understanding its etiology can assist with prognosis and counseling of families. In addition, awareness of treatment strategies including the many hearing device options, cochlear implant, and assistive devices can help direct management of the patient to optimize outcomes.
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Affiliation(s)
- Judith E C Lieu
- Department of Otolaryngology-Head and Neck Surgery, Washington University in St Louis, St Louis, Missouri
| | - Margaret Kenna
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts
- Department of Otolaryngology, Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts
| | - Samantha Anne
- Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Lisa Davidson
- Department of Otolaryngology-Head and Neck Surgery, Washington University in St Louis, St Louis, Missouri
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Lund E. The Relation Between Vocabulary Knowledge and Phonological Awareness in Children With Cochlear Implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:2386-2402. [PMID: 32640175 PMCID: PMC7838843 DOI: 10.1044/2020_jslhr-19-00259] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/17/2019] [Accepted: 04/21/2020] [Indexed: 06/01/2023]
Abstract
Purpose The purpose of this study was to evaluate the relation between lexical knowledge and phonological awareness performance of children with cochlear implants. Method Thirty children with cochlear implants (aged 5-7 years), 30 children with normal hearing matched for age, and 30 children with normal hearing matched for vocabulary size participated in the study. Children completed a vocabulary knowledge measure and three phonological awareness tasks with words that had high and low neighborhood density. Results Children with cochlear implants performed more poorly than their age-matched peers and similarly to their vocabulary-matched peers on phonological awareness tasks. When performance was analyzed according to the neighborhood density of the target word, children with cochlear implants and age-matched children performed better with high-density words. Across all groups, vocabulary size correlated significantly with phonological awareness performance. Conclusion Children with cochlear implants demonstrate delays in both vocabulary knowledge and phonological awareness performance, but children with cochlear implants appear to take advantage of lexical information similarly to their age-matched peers.
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Affiliation(s)
- Emily Lund
- Davies School of Communication Sciences & Disorders, Texas Christian University, Fort Worth
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Ayas M, Ali Al Amadi AMH, Khaled D, Alwaa AM. Impact of COVID-19 on the access to hearing health care services for children with cochlear implants: a survey of parents. F1000Res 2020; 9:690. [PMID: 32760579 PMCID: PMC7376500 DOI: 10.12688/f1000research.24915.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2020] [Indexed: 01/09/2023] Open
Abstract
Background: The COVID-19 pandemic has affected the world in an unprecedented manner. It has aggravated psychological distress in parents of children with cochlear implants. Continuous use of a speech sound processor is critical for auditory stimulation in children with cochlear implants. However, movement restrictions imposed have affected access to hearing healthcare services. The current study explores the impact of the COVID-19 pandemic on hearing healthcare access for children with cochlear implants. Methods: An online questionnaire survey was conducted among parents of children with cochlear implants. Results: A total of 24 parents responded to the questionnaire. All the respondents reported that COVID-19 has a significant impact on access to hearing health services for their children. Speech processor breakdown and disconnection from the auditory mode of communication had a critical influence on behavioral changes in children. Conclusions: The current study highlights the hurdles faced by the parents in order to access hearing health services for their children. The use of innovative methods such as remote tele-audiology will be the way forward to tackle challenges faced by the parents.
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Affiliation(s)
- Mohammed Ayas
- University Hospital Sharjah, Sharjah, 72772, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, 72772, United Arab Emirates
| | - Ahmad Mohd Haider Ali Al Amadi
- University Hospital Sharjah, Sharjah, 72772, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, 72772, United Arab Emirates
| | - Duaa Khaled
- University Hospital Sharjah, Sharjah, 72772, United Arab Emirates
| | - Ahmad Munzer Alwaa
- University Hospital Sharjah, Sharjah, 72772, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, 72772, United Arab Emirates
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Guerzoni L, Mancini P, Nicastri M, Fabrizi E, Giallini I, Cuda D. Does early cochlear implantation promote better reading comprehension skills? Int J Pediatr Otorhinolaryngol 2020; 133:109976. [PMID: 32163823 DOI: 10.1016/j.ijporl.2020.109976] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/22/2020] [Accepted: 02/29/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE to investigate the effect of age at CI activation and to explore the role of other variables such as linguistic skills, stimulation modality and gender on reading comprehension. STUDY DESIGN Prospective observational nonrandomized study. METHODS 89 children with profound congenital sensorineural hearing loss were included in the study. The mean age at CI activation was 21 months (DS ± 11; range 7-50). The Italian reading standardized test, "Prove di lettura MT", was used to assess reading comprehension. The individual raw data MT score were converted into z scores (expected values: means = 0 and SD = 1). The positive values indicated better performance and negative values indicated worse performance. RESULTS Early implanted children achieved significantly better reading comprehension skills, 55 out of 89 children are within 1 SD from the overall mean. 34 children (38.2%) attainted MT z-scores less than 1 SD below the mean. Children with unilateral CI performed somewhat worse if compared to bilateral CI and bimodal stimulation mode, although the differences were weakly significant from a statistical point of view. A strong and positive correlation (rho .69, p < .001) was found with the lexical and morphosyntactic comprehension (rho .70, p < .001). Not significantly different values were observed for gender and parental education level. CONCLUSION Early cochlear implantation promoted better development of reading skills in children with cochlear implantation. LEVEL OF EVIDENCES: outcomes research.
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Affiliation(s)
- Letizia Guerzoni
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, Via Cantone Del Cristo 40, 29121, Piacenza, Italy.
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Viale Dell'Universita 31, 00161, Rome, Italy
| | - Maria Nicastri
- Department of Sense Organs, Sapienza University of Rome, Viale Dell'Universita 31, 00161, Rome, Italy
| | - Enrico Fabrizi
- Department of Economics and Social Sciences, Universita Cattolica Del S. Cuore, Via Emilia Parmense 84, 29122, Piacenza, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University of Rome, Viale Dell'Universita 31, 00161, Rome, Italy
| | - Domenico Cuda
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, Via Cantone Del Cristo 40, 29121, Piacenza, Italy
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Sidera F, Morgan G, Serrat E. Understanding Pretend Emotions in Children Who Are Deaf and Hard of Hearing. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2020; 25:141-152. [PMID: 31828338 DOI: 10.1093/deafed/enz040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 06/10/2023]
Abstract
Children who are deaf and hard of hearing (DHH) and born to hearing parents have delays in their social-cognitive development and in particular in their theory of mind (ToM). These delays are often attributed to the difficulties they encounter in acquiring age-appropriate linguistic and communicative skills. The present study asks whether this developmental delay extends to problems with understanding pretend emotions and if linguistic difficulties are related to this area. A total of 173 children (82 DHH and 91 hearing) between 3 and 8 years of age received a set of emotion and language measures. Results showed that children who are DHH were delayed in understanding pretend emotions, and this was strongly related to their difficulties with expressive vocabulary and pragmatics. In summary, children who are DHH and have experienced reduced access to language and communicative interaction have a restricted understanding of the communicative intentions of emotional expressions. These delays may have implications for their social relationships with surrounding family and other children.
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Ingvalson EM, Grieco-Calub TM, Perry LK, VanDam M. Rethinking Emergent Literacy in Children With Hearing Loss. Front Psychol 2020; 11:39. [PMID: 32082217 PMCID: PMC7006043 DOI: 10.3389/fpsyg.2020.00039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 01/08/2020] [Indexed: 12/01/2022] Open
Abstract
Long-term literacy outcomes for children with hearing loss, particularly those with severe-to-profound deafness who are fitted with cochlear implants (CIs) lag behind those of children with normal hearing (NH). The causes for these long-term deficits are not fully clear, though differences in auditory access between children who use CIs and those with NH may be a partial cause. This paper briefly reviews the emergent literacy model as proposed by Whitehurst and Lonigan (1998). We then examine the development of each of Whitehurst and Lonigan’s identified factors in children who use CIs and how the extant knowledge of language and literacy development in children who use CIs may bear on the emergent literacy model. We then propose to modify the model for children who use CIs based on their unique developmental trajectories, influenced at least in part by their unique auditory access. We conclude with future directions for further development of an evidence-based emergent literacy model for children who use CIs and how this model could be used to inform intervention.
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Affiliation(s)
- Erin M Ingvalson
- School of Communication Science and Disorders, Florida State University, Tallahassee, FL, United States
| | - Tina M Grieco-Calub
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - Lynn K Perry
- Department of Psychology, University of Miami, Coral Gables, FL, United States
| | - Mark VanDam
- Department of Speech and Hearing Sciences, Washington State University, Spokane, WA, United States
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48
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Al-Salim S, Moeller MP, McGregor KK. Performance of Children With Hearing Loss on an Audiovisual Version of a Nonword Repetition Task. Lang Speech Hear Serv Sch 2020; 51:42-54. [PMID: 31913807 DOI: 10.1044/2019_lshss-ochl-19-0016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose The aims of this study were to (a) determine if a high-quality adaptation of an audiovisual nonword repetition task can be completed by children with wide-ranging hearing abilities and to (b) examine whether performance on that task is sensitive to child demographics, hearing status, language, working memory, and executive function abilities. Method An audiovisual version of a nonword repetition task was adapted and administered to 100 school-aged children grouped by hearing status: 35 with normal hearing, 22 with mild bilateral hearing loss, 17 with unilateral hearing loss, and 26 cochlear implant users. Participants also completed measures of vocabulary, working memory, and executive function. A generalized linear mixed-effects model was used to analyze performance on the nonword repetition task. Results All children were able to complete the nonword repetition task. Children with unilateral hearing loss and children with cochlear implants repeated nonwords with less accuracy than normal-hearing peers. After adjusting for the influence of vocabulary and working memory, main effects were found for syllable length and hearing status, but no interaction effect was observed. Conclusions The audiovisual nonword repetition task captured individual differences in the performance of children with wide-ranging hearing abilities. The task could act as a useful tool to aid in identifying children with unilateral or mild bilateral hearing loss who have language impairments beyond those imposed by the hearing loss.
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Affiliation(s)
- Sarah Al-Salim
- Center for Childhood Deafness, Language & Learning, Boys Town National Research Hospital, Omaha, NE
| | - Mary Pat Moeller
- Center for Childhood Deafness, Language & Learning, Boys Town National Research Hospital, Omaha, NE
| | - Karla K McGregor
- Center for Childhood Deafness, Language & Learning, Boys Town National Research Hospital, Omaha, NE
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Davidson LS, Geers AE, Hale S, Sommers MM, Brenner C, Spehar B. Effects of Early Auditory Deprivation on Working Memory and Reasoning Abilities in Verbal and Visuospatial Domains for Pediatric Cochlear Implant Recipients. Ear Hear 2019; 40:517-528. [PMID: 31026238 PMCID: PMC8336888 DOI: 10.1097/aud.0000000000000629] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The overall goal of this study was to compare verbal and visuospatial working memory in children with normal hearing (NH) and with cochlear implants (CI). The main questions addressed by this study were (1) Does auditory deprivation result in global or domain-specific deficits in working memory in children with CIs compared with their NH age mates? (2) Does the potential for verbal recoding affect performance on measures of reasoning ability in children with CIs relative to their NH age mates? and (3) Is performance on verbal and visuospatial working memory tasks related to spoken receptive language level achieved by children with CIs? DESIGN A total of 54 children ranging in age from 5 to 9 years participated; 25 children with CIs and 29 children with NH. Participants were tested on both simple and complex measures of verbal and visuospatial working memory. Vocabulary was assessed with the Peabody Picture Vocabulary Test (PPVT) and reasoning abilities with two subtests of the WISC-IV (Wechsler Intelligence Scale for Children, 4th edition): Picture Concepts (verbally mediated) and Matrix Reasoning (visuospatial task). Groups were compared on all measures using analysis of variance after controlling for age and maternal education. RESULTS Children with CIs scored significantly lower than children with NH on measures of working memory, after accounting for age and maternal education. Differences between the groups were more apparent for verbal working memory compared with visuospatial working memory. For reasoning and vocabulary, the CI group scored significantly lower than the NH group for PPVT and WISC Picture Concepts but similar to NH age mates on WISC Matrix Reasoning. CONCLUSIONS Results from this study suggest that children with CIs have deficits in working memory related to storing and processing verbal information in working memory. These deficits extend to receptive vocabulary and verbal reasoning and remain even after controlling for the higher maternal education level of the NH group. Their ability to store and process visuospatial information in working memory and complete reasoning tasks that minimize verbal labeling of stimuli more closely approaches performance of NH age mates.
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Affiliation(s)
| | | | | | | | | | - Brent Spehar
- Washington University School of Medicine, St. Louis, MO, USA
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50
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Huber M, Havas C. Restricted Speech Recognition in Noise and Quality of Life of Hearing-Impaired Children and Adolescents With Cochlear Implants - Need for Studies Addressing This Topic With Valid Pediatric Quality of Life Instruments. Front Psychol 2019; 10:2085. [PMID: 31572268 PMCID: PMC6751251 DOI: 10.3389/fpsyg.2019.02085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 08/27/2019] [Indexed: 11/27/2022] Open
Abstract
Cochlear implants (CI) support the development of oral language in hearing-impaired children. However, even with CI, speech recognition in noise (SRiN) is limited. This raised the question, whether these restrictions are related to the quality of life (QoL) of children and adolescents with CI and how SRiN and QoL are related to each other. As a result of a systematic literature research only three studies were found, indicating positive moderating effects between SRiN and QoL of young CI users. Thirty studies addressed the quality of life of children and adolescents with CI. Following the criteria of the World Health Organization (WHO) for pediatric health related quality of life HRQoL (1994) only a minority used validated child centered and age appropriate QoL instruments. Moreover, despite the consensus that usually children and adolescents are the most prominent informants of their own QoL (parent-reports complement the information of the children) only a minority of investigators used self-reports. Restricted SRiN may be a burden for the QoL of children and adolescents with CI. Up to now the CI community does not seem to have focused on a possible impairment of QoL in young CI users. Further studies addressing this topic are urgently needed, which is also relevant for parents, clinicians, therapists, teachers, and policy makers. Additionally investigators should use valid pediatric QoL instruments. Most of the young CI users are able to inform about their quality of life themselves.
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Affiliation(s)
- Maria Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Clara Havas
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
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