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Nagels L, Gaudrain E, Vickers D, Hendriks P, Başkent D. Prelingually Deaf Children With Cochlear Implants Show Better Perception of Voice Cues and Speech in Competing Speech Than Postlingually Deaf Adults With Cochlear Implants. Ear Hear 2024; 45:952-968. [PMID: 38616318 PMCID: PMC11175806 DOI: 10.1097/aud.0000000000001489] [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: 12/29/2022] [Accepted: 01/10/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVES Postlingually deaf adults with cochlear implants (CIs) have difficulties with perceiving differences in speakers' voice characteristics and benefit little from voice differences for the perception of speech in competing speech. However, not much is known yet about the perception and use of voice characteristics in prelingually deaf implanted children with CIs. Unlike CI adults, most CI children became deaf during the acquisition of language. Extensive neuroplastic changes during childhood could make CI children better at using the available acoustic cues than CI adults, or the lack of exposure to a normal acoustic speech signal could make it more difficult for them to learn which acoustic cues they should attend to. This study aimed to examine to what degree CI children can perceive voice cues and benefit from voice differences for perceiving speech in competing speech, comparing their abilities to those of normal-hearing (NH) children and CI adults. DESIGN CI children's voice cue discrimination (experiment 1), voice gender categorization (experiment 2), and benefit from target-masker voice differences for perceiving speech in competing speech (experiment 3) were examined in three experiments. The main focus was on the perception of mean fundamental frequency (F0) and vocal-tract length (VTL), the primary acoustic cues related to speakers' anatomy and perceived voice characteristics, such as voice gender. RESULTS CI children's F0 and VTL discrimination thresholds indicated lower sensitivity to differences compared with their NH-age-equivalent peers, but their mean discrimination thresholds of 5.92 semitones (st) for F0 and 4.10 st for VTL indicated higher sensitivity than postlingually deaf CI adults with mean thresholds of 9.19 st for F0 and 7.19 st for VTL. Furthermore, CI children's perceptual weighting of F0 and VTL cues for voice gender categorization closely resembled that of their NH-age-equivalent peers, in contrast with CI adults. Finally, CI children had more difficulties in perceiving speech in competing speech than their NH-age-equivalent peers, but they performed better than CI adults. Unlike CI adults, CI children showed a benefit from target-masker voice differences in F0 and VTL, similar to NH children. CONCLUSION Although CI children's F0 and VTL voice discrimination scores were overall lower than those of NH children, their weighting of F0 and VTL cues for voice gender categorization and their benefit from target-masker differences in F0 and VTL resembled that of NH children. Together, these results suggest that prelingually deaf implanted CI children can effectively utilize spectrotemporally degraded F0 and VTL cues for voice and speech perception, generally outperforming postlingually deaf CI adults in comparable tasks. These findings underscore the presence of F0 and VTL cues in the CI signal to a certain degree and suggest other factors contributing to the perception challenges faced by CI adults.
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Affiliation(s)
- Leanne Nagels
- Center for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, The Netherlands
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands
| | - Etienne Gaudrain
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands
- CNRS UMR 5292, Lyon Neuroscience Research Center, Auditory Cognition and Psychoacoustics, Inserm UMRS 1028, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Deborah Vickers
- Cambridge Hearing Group, Sound Lab, Clinical Neurosciences Department, University of Cambridge, Cambridge, United Kingdom
| | - Petra Hendriks
- Center for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, The Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands
| | - Deniz Başkent
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Research School of Behavioural and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands
- W.J. Kolff Institute for Biomedical Engineering and Materials Science, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Poupore NS, Chidarala S, Morris NS, McRackan TR, Schvartz-Leyzac KC. Impact of auditory environments on language outcomes in children with a cochlear implant. Int J Audiol 2024; 63:510-518. [PMID: 37293929 DOI: 10.1080/14992027.2023.2216875] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 05/17/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To analyse the effects of auditory environments on receptive and expressive language outcomes in children with a CI. DESIGN A single-institution retrospective review was performed. The auditory environments included Speech-Noise, Speech-Quiet, Quiet, Music, and Noise. Hearing Hour Percentage (HHP) and percent total hours were calculated for each environment. Generalised Linear Mixed Models (GLMM) analyses were used to study the effects of auditory environments on PLS Receptive and Expressive scores. STUDY SAMPLE Thirty-nine children with CI. RESULTS On GLMM, an increase in Quiet HHP and Quiet percent total hours were positively associated with PLS Receptive scores. Speech-Quiet, Quiet, and Music HHP were positively associated with PLS Expressive scores, with only Quiet being significant for percent total hours. In contrast, percent total hours of Speech-Noise and Noise had a significant negative association with PLS Expressive scores. CONCLUSIONS This study suggests that more time spent in a quiet auditory environment positively influences PLS Receptive and Expressive scores and that more time listening to speech in quiet and music positively influences PLS Expressive scores. Time spent in environments recognised as Speech-Noise and Noise might negatively impact a child's expressive language outcomes with a CI. Future research is needed to better understand this association.
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Affiliation(s)
- Nicolas S Poupore
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
- School of Medicine, University of South Carolina Greenville, Greenville, SC, USA
| | - Shreya Chidarala
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Nevitte S Morris
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Theodore R McRackan
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Kara C Schvartz-Leyzac
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
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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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de Graaff F, Huysmans E, Merkus P, Goverts ST, Kramer SE, Smits C. Manual switching between programs intended for specific real-life listening environments by adult cochlear implant users: do they use the intended program? Int J Audiol 2024:1-8. [PMID: 38445654 DOI: 10.1080/14992027.2024.2321153] [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: 01/12/2023] [Accepted: 02/13/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE The aim of the current study was to investigate the use of manually and automatically switching programs in everyday day life by adult cochlear implant (CI) users. DESIGN Participants were fitted with an automatically switching sound processor setting and 2 manual programs for 3-week study periods. They received an extensive counselling session. Datalog information was used to analyse the listening environments identified by the sound processor, the program used and the number of program switches. STUDY SAMPLES Fifteen adult Cochlear CI users. Average age 69 years (range: 57-85 years). RESULTS Speech recognition in noise was significantly better with the "noise" program than with the "quiet" program. On average, participants correctly classified 4 out of 5 listening environments in a laboratory setting. Participants switched, on average, less than once a day between the 2 manual programs and the sound processor was in the intended program 60% of the time. CONCLUSION Adult CI users switch rarely between two manual programs and leave the sound processor often in a program not intended for the specific listening environment. A program that switches automatically between settings, therefore, seems to be a more appropriate option to optimise speech recognition performance in daily listening environments.
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Affiliation(s)
- Feike de Graaff
- Amsterdam UMC Location Vrije Universiteit, Department of Otolaryngology - Head and Neck Surgery, Section Ear & Hearing, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Elke Huysmans
- Amsterdam UMC Location Vrije Universiteit, Department of Otolaryngology - Head and Neck Surgery, Section Ear & Hearing, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Paul Merkus
- Amsterdam UMC Location Vrije Universiteit, Department of Otolaryngology - Head and Neck Surgery, Section Ear & Hearing, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - S Theo Goverts
- Amsterdam UMC Location Vrije Universiteit, Department of Otolaryngology - Head and Neck Surgery, Section Ear & Hearing, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Sophia E Kramer
- Amsterdam UMC Location Vrije Universiteit, Department of Otolaryngology - Head and Neck Surgery, Section Ear & Hearing, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Cas Smits
- Amsterdam UMC Location University of Amsterdam, Department of Otolaryngology - Head and Neck Surgery, Section Ear & Hearing, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Awad DR, Tang AJ, Venskytis EJ, Levy R, Kitsko DJ, Shaffer AD, Chi DH. Socioeconomic status and pediatric cochlear implant usage during COVID-19. Int J Pediatr Otorhinolaryngol 2024; 176:111800. [PMID: 38007839 DOI: 10.1016/j.ijporl.2023.111800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/28/2023] [Accepted: 11/19/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVE COVID-19 (COVID) delayed access to speech and hearing services. The objective of this study was to identify interactions between socioeconomic status (SES) and cochlear implant (CI) usage during COVID. METHODS Consecutive pediatric patients (age 0-17) with CI and audiology visits between 2019 and 2022 at a tertiary care children's hospital were reviewed. Age, sex, race, insurance type, and proxy measures for SES using zip code were recorded. Hours spent with CI on and in different listening environments were compared between pre-COVID (1/1/2019-12/31/2019), COVID (4/1/2020-3/31/2021), and most recent (6/1/2021-5/31/2022) time periods. RESULTS Most patients were male (32/59, 54 % ears of 48 patients) and White, non-Hispanic (45/59, 76 %). Median age at implant was 2.0 years (range:0.6-12.2). There were no significant differences in hours spent with CI on during COVID compared with pre-COVID. However, children spent more time listening to louder noises (70-79 dB and ≥80 dB) recently compared with during COVID (p = 0.01 and 0.006, respectively). During COVID, children living in areas with greater educational attainment showed smaller reductions in total hours with CI on (β = 0.1, p = 0.02) and hours listening to speech in noise (β = 0.03, p = 0.005) compared with pre-COVID. In the most recent time period, children of minority race (β = -3.94 p = 0.008) and those who were older at implant (β = -0.630, p = 0.02) were more likely to experience reductions in total hours with CI on compared with during COVID. CONCLUSION Interventions which mitigate barriers of implant use and promote rich listening home-environments for at risk populations should be implemented during challenging future social and environmental conditions.
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Affiliation(s)
- Daniel R Awad
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Anthony J Tang
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Emily J Venskytis
- Department of Audiology and Speech-Language Pathology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Rena Levy
- Department of Audiology and Speech-Language Pathology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Dennis J Kitsko
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Amber D Shaffer
- Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - David H Chi
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
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Awad DR, Castaño JE, McCoy JL, Levy R, Oberlies NR, Shaffer AD, Kitsko DJ, Jabbour N, Chi DH. Socioeconomic Status and Cochlear Implant Usage: A Datalogging Study. Ann Otol Rhinol Laryngol 2023; 132:1535-1542. [PMID: 37096343 DOI: 10.1177/00034894231170588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
OBJECTIVE To evaluate the associations between proxy measures of socioeconomic status (SES) and usage of cochlear implants. STUDY DESIGN Retrospective case series. METHODS Usage outcomes were measured among patients with a cochlear implant and data logging at a tertiary care children's hospital between 2002 and 2017. Time per day with cochlear implant turned on, coil off, and listening to speech in noise and speech in quiet were extracted from audiology records, averaging right and left ear usage for those with bilateral implants. Associations between cochlear implant usage and demographic factors such as insurance type and median household income for zip code were assessed. RESULTS There were 142 total patients; 74 had bilateral usage data. Mean on air time was 10.76 hours (SD: 4.4). Those with private insurance had 1.2 hour more on air time/day (P = .047) and 0.9 hour more quiet time/day (P = .011) compared to those with public insurance. Younger age at last visit was associated with increased speech in quiet (B = -.08; 95% CI: -0.12-[-0.05], P < .001) and coil off (B = -0.06; 95% CI: -0.11-[-0.02], P = .006). Younger age at implant was associated with longer duration since last data logging visit (B = -10.46; 95% CI: -18.41-[-2.51], P = .010), more daily use (on air; B = -0.23; 95% CI: -0.43-[-0.03], P = .026), and increased time spent listening to speech in noise (B = -0.07; 95% CI: -0.14-[-0.01], P = .024). No other significant associations between datalogging output and each proxy SES factor were found. CONCLUSIONS Lack of private insurance and older age at implantation decreased access to binaural hearing for children and young adults with cochlear implants.
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Affiliation(s)
- Daniel R Awad
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Jennifer L McCoy
- Division of Paediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
- Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Rena Levy
- Department of Audiology and Speech-Language Pathology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Nicholas R Oberlies
- Department of Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Amber D Shaffer
- Division of Paediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Dennis J Kitsko
- Division of Paediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
- Department of Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Noel Jabbour
- Division of Paediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
- Department of Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - David H Chi
- Division of Paediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
- Department of Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
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Lindquist NR, Dietrich MS, Patro A, Henry MR, DeFreese AJ, Freeman MH, Perkins EL, Gifford RH, Haynes DS, Holder JT. Early Datalogging Predicts Cochlear Implant Performance: Building a Recommendation for Daily Device Usage. Otol Neurotol 2023; 44:e479-e485. [PMID: 37442607 PMCID: PMC10361622 DOI: 10.1097/mao.0000000000003917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
OBJECTIVE To quantify the effect of datalogging on speech recognition scores and time to achievement for a "benchmark" level of performance within the first year, and to provide a data-driven recommendation for minimum daily cochlear implant (CI) device usage to better guide patient counseling and future outcomes. STUDY DESIGN Retrospective cohort. SETTING Tertiary referral center. PATIENTS Three hundred thirty-seven adult CI patients with data logging and speech recognition outcome data who were implanted between August 2015 and August 2020. MAIN OUTCOME MEASURES Processor datalogging, speech recognition scores, achievement of "benchmark speech recognition performance" defined as 80% of the median score for speech recognition outcomes at our institution. RESULTS The 1-month datalogging measure correlated positively with word and sentences scores at 1, 3, 6, and 12 months postactivation. Compared with age, sex, and preoperative performance, datalogging was the largest predictive factor of benchmark achievement on multivariate analysis. Each hour/day increase of device usage at 1 month resulted in a higher likelihood of achieving benchmark consonant-nucleus-consonant and AzBio scores within the first year (odds ratio = 1.21, p < 0.001) as well as earlier benchmark achievement. Receiver operating characteristic curve analysis identified the optimal data logging threshold at an average of 12 hours/day. CONCLUSIONS Early CI device usage, as measured by 1-month datalogging, predicts benchmark speech recognition achievement in adults. Datalogging is an important predictor of CI performance within the first year postimplantation. These data support the recommended daily CI processor utilization of at least 12 hours/day to achieve optimal speech recognition performance for most patients.
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Affiliation(s)
- Nathan R Lindquist
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mary S Dietrich
- Vanderbilt University Schools of Medicine (Biostatistics, VICC, Psychiatry) and Nursing, Nashville, Tennessee
| | - Ankita Patro
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Melissa R Henry
- Division of Audiology, Henry Ford Health, Dearborn, Michigan
| | - Andrea J DeFreese
- Department of Hearing and Speech Sciences, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Michael H Freeman
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Elizabeth L Perkins
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - René H Gifford
- Department of Hearing and Speech Sciences, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - David S Haynes
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jourdan T Holder
- Department of Hearing and Speech Sciences, Vanderbilt Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, Tennessee
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Glaubitz C, Liebscher T, Hoppe U. Children with cochlear implant and additional disabilities benefit from consistent device use. Int J Pediatr Otorhinolaryngol 2022; 162:111301. [PMID: 36096038 DOI: 10.1016/j.ijporl.2022.111301] [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: 03/29/2022] [Revised: 08/08/2022] [Accepted: 08/27/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Although the prevalence of additional disabilities (AD) in children with a cochlear implant (CI) is high, children with such disabilities are often excluded from clinical studies, or their specific characteristics are only partially included. The literature shows that several factors need to be considered in evaluating auditory and language development in CI children with AD, including demographic variables as well as the severity and type of disability. Current findings on device use in children show correlations with auditory and language outcome, but little is known about device use specifically in children with AD. The purpose of this study was to determine the auditory and language outcome of CI children with AD and to analyse their datalogging-based daily device use, both 1 year and 2 years after implantation. In addition, any potential correlations between outcome and device use were to be identified. METHODS A cohort of 32 CI children with 5 different types of AD were included in this retrospective analysis. The children's auditory and language outcome was assessed by the parental questionnaires LittlEARS and ELFRA and by the professional observation tool CAP (Categories of Auditory Performance) 1 and 2 years after implantation. Longitudinal device use was analysed by using the CI system-integrated data-logging; daily duration of CI use, number of coil disconnections and exposure to different listening scenes were recorded. RESULTS Overall, the cohort's auditory and language performance showed significant progress over time, while reduced abilities became more obvious after 2 years of CI experience. The mean daily duration of CI use increased significantly from 7.8 ± 2.8 to 8.2 ± 2.7 h after 2 years. High numbers of daily coil disconnections were detected, with a significant mean decrease from 83.4 ± 73.1 to 66.3 ± 54.6 whereas the percentage exposure to different listening environments was widely stable over time. Significant rank correlations were identified between outcomes measured by ELFRA and CAP with daily duration of CI use, numbers of coil disconnections and percentage of exposure to speech-characterised listening scenes. CONCLUSION The auditory and language outcome in CI children with AD is variable, but it progresses over time. Children benefit from a consistent daily device use as well as from a high exposure to speech-characterised environments. Device use should be monitored constantly, with particular focus on daily duration of CI use and, in particular, on the number of coil disconnections if children have a severe motor impairment. Objective data-logging is an important addition to outcome assessment by testing, observations and parental questionnaires. Although assessment in children with AD is a major challenge for professionals, comprehensive assessment is needed to improve cochlear implant services with special adaption to children with AD, and this should include audiological, development-related and psychosocial information. A unified system to classify types of disabilities could help to improve procedures for analysing different outcomes.
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Affiliation(s)
- Cynthia Glaubitz
- Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, ENT-clinic, Department of Audiology and Cochlear Implant Centre, Waldstr.1, 91054, Erlangen, Germany.
| | - Tim Liebscher
- Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, ENT-clinic, Department of Audiology and Cochlear Implant Centre, Waldstr.1, 91054, Erlangen, Germany
| | - Ulrich Hoppe
- Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, ENT-clinic, Department of Audiology and Cochlear Implant Centre, Waldstr.1, 91054, Erlangen, Germany
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Urík M, Šikolová S, Hošnová D, Kruntorád V, Bartoš M, Jabandžiev P. Long-Term Device Satisfaction and Safety after Cochlear Implantation in Children. J Pers Med 2022; 12:jpm12081326. [PMID: 36013275 PMCID: PMC9410025 DOI: 10.3390/jpm12081326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 12/02/2022] Open
Abstract
(1) Objectives: For full benefit in children implanted with a cochlear implant (CI), wearing the device all waking hours is necessary. This study focuses on the relationship between daily use and audiological outcomes, with the hypothesis that frequent daily device use coincides with high device satisfaction resulting in better functional gain (FG). Confounding factors such as implantation age, device experience and type of device were considered. (2) Results: Thirty-eight CI children (65 ears) were investigated. In total, 76.92% of the children were using their device for >12 h per day (h/d), 18.46% for 9−12 h/d, the remaining for 6−9 h/d and one subject reported 3 h/d. The revision rate up to the 90-month follow-up (F/U) was 4.6%. The mean FG was 59.00 ± 7.67 dB. The Audio Processor Satisfaction Questionnaire (APSQ) separated for single unit (SU) versus behind the ear (BTE) devices showed significantly better results for the latter in terms of wearing comfort (WC) (p = 0.00062). A correlation between device use and FG was found with a device experience of <2 years (n = 29; r2 = 0.398), whereas no correlation was seen with ≥2 years of device experience (n = 36; r2 = 0.0038). (3) Conclusion: This study found significant relationships between daily device use and FG, wearing comfort and long-term safety (90 months).
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Affiliation(s)
- Milan Urík
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300 Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
- Correspondence: ; Tel.: +420-532-234-440
| | - Soňa Šikolová
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300 Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
| | - Dagmar Hošnová
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300 Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
| | - Vít Kruntorád
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300 Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
| | - Michal Bartoš
- Department of Pediatric Otorhinolaryngology, University Hospital Brno, Černopolní 9, 61300 Brno, Czech Republic
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
| | - Petr Jabandžiev
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 62500 Brno, Czech Republic
- Department of Pediatrics, University Hospital Brno, 61300 Brno, Czech Republic
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10
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Longitudinal auditory data of children with prelingual single-sided deafness managed with early cochlear implantation. Sci Rep 2022; 12:9376. [PMID: 35672363 PMCID: PMC9174487 DOI: 10.1038/s41598-022-13247-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 05/23/2022] [Indexed: 11/09/2022] Open
Abstract
Individuals with single-sided deafness (SSD) have no access to binaural hearing, which limits their ability to localize sounds and understand speech in noisy environments. In addition, children with prelingual SSD are at risk for neurocognitive and academic difficulties. Early cochlear implantation may lead to improved hearing outcomes by restoring bilateral hearing. However, its longitudinal impact on the development of children with SSD remains unclear. In the current study, a group of young children with prelingual SSD received a cochlear implant at an early age. From the age of four, the children’s spatial hearing skills could be assessed using a spatial speech perception in noise test and a sound localization test. The results are compared to those of two control groups: children with SSD without a cochlear implant and children with bilateral normal hearing. Overall, the implanted group exhibited improved speech perception in noise abilities and better sound localization skills, compared to their non-implanted peers. On average, the children wore their device approximately nine hours a day. Given the large contribution of maturation to the development of spatial hearing skills, further follow-up is important to understand the long-term benefit of a cochlear implant for children with prelingual SSD.
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Busch T, Brinchmann EI, Braeken J, Wie OB. Receptive Vocabulary of Children With Bilateral Cochlear Implants From 3 to 16 Years of Age. Ear Hear 2022; 43:1866-1880. [PMID: 35426854 PMCID: PMC9592181 DOI: 10.1097/aud.0000000000001220] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The vocabulary of children with cochlear implants is often smaller than that of their peers with typical hearing, but there is uncertainty regarding the extent of the differences and potential risks and protective factors. Some studies indicate that their receptive vocabulary develops well at first, but that they fail to keep up with their typical hearing peers, causing many CI users to enter school with a receptive vocabulary that is not age-appropriate. To better understand the receptive vocabulary abilities of children with cochlear implants this study explored age-related differences to matched children with typical hearing and associations between vocabulary skills and child-level characteristics. DESIGN A retrospective cross-sectional study with matched controls was conducted at the Norwegian national cochlear implant center at Oslo University Hospital. Eighty-eight children (mean age 8.7 years; range 3.2 to 15.9; 43 girls, 45 boys) who had received bilateral cochlear implants before 3 years of age were compared with two groups of children with typical hearing. One group was matched for maternal education, sex, and chronological age, the other group was matched for maternal education, sex, and hearing age. Receptive vocabulary performance was measured with the British Picture Vocabulary Scale. RESULTS Cochlear implant users' receptive vocabulary was poorer than that of age-matched children with typical hearing ( M = 84.6 standard points, SD = 21.1; children with typical hearing: M = 102.1 standard points, SD = 15.8; mean difference -17.5 standard points, 95% CI [-23.0 to -12.0], p < 0.001; Hedges's g = -0.94, 95% CI [-1.24 to -0.62]), and children with cochlear implants were significantly more likely to perform below the normative range (risk ratio = 2.2, 95% CI [1.42 to 3.83]). However, there was a significant nonlinear U-shaped effect of age on the scores of cochlear implant users, with the difference to the matched typical hearing children being largest (23.9 standard points, on average) around 8.7 years of age and smaller toward the beginning and end of the age range. There was no significant difference compared with children with typical hearing when differences in auditory experience were accounted for. Variability was not significantly different between the groups. Further analysis with a random forest revealed that, in addition to chronological age and hearing age, simultaneous versus sequential implantation, communication mode at school, and social integration were predictors of cochlear implant users' receptive vocabulary. CONCLUSIONS On average, the receptive vocabulary of children with cochlear implants was smaller than that of their typical hearing peers. The magnitude of the difference was changing with age and was the largest for children in early primary school. The nonlinear effect of age might explain some of the ambiguity in previous research findings and could indicate that better intervention is required around school entry. The results emphasize that continuous monitoring and support are crucial to avoid far-reaching negative effects on the children's development and well-being.
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Affiliation(s)
- Tobias Busch
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | | | - Johan Braeken
- Centre for Educational Measurement, University of Oslo, Oslo, Norway
| | - Ona Bø Wie
- Department of Special Needs Education, University of Oslo, Oslo, Norway,Department of Otolaryngology, Oslo University Hospital, Oslo, Norway
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12
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American Cochlear Implant Alliance Task Force Guidelines for Determining Cochlear Implant Candidacy in Children. Ear Hear 2022; 43:268-282. [PMID: 35213891 PMCID: PMC8862774 DOI: 10.1097/aud.0000000000001087] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article summarizes the available evidence on pediatric cochlear implantation to provide current guidelines for clinical protocols and candidacy recommendations in the United States. Candidacy determination involves specification of audiologic and medical criteria per guidelines of the Food and Drug Administration. However, recommendations for a cochlear implant evaluation also should maintain flexibility and consider a child’s skill progression (i.e., month-for-month progress in speech, language, and auditory development) and quality of life with appropriately fit hearing aids. Moreover, evidence supports medical and clinical decisions based on other factors, including (a) ear-specific performance, which affords inclusion of children with asymmetric hearing loss and single-sided deafness as implant candidates; (b) ear-specific residual hearing, which influences surgical technique and device selection to optimize hearing; and (c) early intervention to minimize negative long-term effects on communication and quality of life related to delayed identification of implant candidacy, later age at implantation, and/or limited commitment to an audiologic rehabilitation program. These evidence-based guidelines for current clinical protocols in determining pediatric cochlear implant candidacy encourage a team-based approach focused on the whole child and the family system.
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13
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Home Auditory Environments of Children With Cochlear Implants and Children With Normal Hearing. Ear Hear 2022; 43:592-604. [PMID: 34582393 PMCID: PMC8881328 DOI: 10.1097/aud.0000000000001124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Early home auditory environment plays an important role in children's spoken language development and overall well-being. This study explored differences in the home auditory environment experienced by children with cochlear implants (CIs) relative to children with normal hearing (NH). DESIGN Measures of the child's home auditory environment, including adult word count (AWC), conversational turns (CTs), child vocalizations (CVs), television and media (TVN), overlapping sound (OLN), and noise (NON), were gathered using the Language Environment Analysis System. The study included 16 children with CIs (M = 22.06 mo) and 25 children with NH (M = 18.71 mo). Families contributed 1 to 3 daylong recordings quarterly over the course of approximately 1 year. Additional parent and infant characteristics including maternal education, amount of residual hearing, and age at activation were also collected. RESULTS The results showed that whereas CTs and CVs increased with child age for children with NH, they did not change as a function of age for children with CIs; NON was significantly higher for the NH group. No significant group differences were found for the measures of AWC, TVN, or OLN. Moreover, measures of CTs, CVs, TVN, and NON from children with CIs were associated with demographic and child factors, including maternal education, age at CI activation, and amount of residual hearing. CONCLUSIONS These findings suggest that there are similarities and differences in the home auditory environment experienced by children with CIs and children with NH. These findings have implications for early intervention programs to promote spoken language development for children with CIs.
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14
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Holder JT, Mayberry LS, Gifford R. The Cochlear Implant Use Questionnaire: Assessing Habits and Barriers to Use. Otol Neurotol 2022; 43:e23-e29. [PMID: 34629441 PMCID: PMC8671178 DOI: 10.1097/mao.0000000000003341] [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] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The objective was to design a questionnaire to identify daily cochlear implant (CI) use habits and barriers to daily CI use and to administer this questionnaire to adult CI users. We hypothesized that recipients who reported a greater number of barriers to daily CI use would show lower daily CI use. STUDY DESIGN Questionnaire. SETTING Academic medical center. PATIENTS Hundred adult CI recipients. MAIN OUTCOME MEASURES Questionnaire responses and amount of CI use per day as measured from the CI software. RESULTS The cochlear implant use questionnaire (CIUQ) was created and responses were obtained from 100 participants. The CIUQ yielded an average overall score of 23 (range, 3-54) out of 100; responses were variable, and CI recipients experienced different barriers to using their CI processor. The CIUQ overall score was significantly correlated with recipients' daily CI use (h/d) (rs = -0.561, p < 0.0001, 95% confidence interval [-0.694, -0.391]), which provides evidence of construct validity. Responses were immediately useful for identifying and overcoming barriers to consistent CI use with our study participants. CONCLUSIONS Increasing evidence suggests that daily CI use is correlated with speech recognition outcomes. To optimize outcomes, clinicians should consider implementing this questionnaire to identify and overcome barriers to consistent, full-time CI processor use.
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Affiliation(s)
| | - Lindsay S Mayberry
- Division of General Internal Medicine & Public Health, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
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15
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Wolfe J, Deroche M, Neumann S, Hanna L, Towler W, Wilson C, Bien AG, Miller S, Schafer EC, Gracco V. Factors Associated with Speech-Recognition Performance in School-Aged Children with Cochlear Implants and Early Auditory-Verbal Intervention. J Am Acad Audiol 2021; 32:433-444. [PMID: 34847584 DOI: 10.1055/s-0041-1730413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Considerable variability exists in the speech recognition abilities achieved by children with cochlear implants (CIs) due to varying demographic and performance variables including language abilities. PURPOSE This article examines the factors associated with speech recognition performance of school-aged children with CIs who were grouped by language ability. RESEARCH DESIGN This is a single-center cross-sectional study with repeated measures for subjects across two language groups. STUDY SAMPLE Participants included two groups of school-aged children, ages 7 to 17 years, who received unilateral or bilateral CIs by 4 years of age. The High Language group (N = 26) had age-appropriate spoken-language abilities, and the Low Language group (N = 24) had delays in their spoken-language abilities. DATA COLLECTION AND ANALYSIS Group comparisons were conducted to examine the impact of demographic characteristics on word recognition in quiet and sentence recognition in quiet and noise. RESULTS Speech recognition in quiet and noise was significantly poorer in the Low Language compared with the High Language group. Greater hours of implant use and better adherence to auditory-verbal (AV) therapy appointments were associated with higher speech recognition in quiet and noise. CONCLUSION To ensure maximal speech recognition in children with low-language outcomes, professionals should develop strategies to ensure that families support full-time CI use and have the means to consistently attend AV appointments.
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Affiliation(s)
- Jace Wolfe
- Hearts for Hearing Foundation, Oklahoma City, Oklahoma
| | - Mickael Deroche
- Department of Psychology, Concordia University, Montreal, Canada
| | - Sara Neumann
- Hearts for Hearing Foundation, Oklahoma City, Oklahoma
| | - Lindsay Hanna
- Hearts for Hearing Foundation, Oklahoma City, Oklahoma
| | - Will Towler
- Hearts for Hearing Foundation, Oklahoma City, Oklahoma
| | - Caleb Wilson
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Alexander G Bien
- Department of Otolaryngology - Head & Neck Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Sharon Miller
- Department of Audiology & Speech-Language Pathology, University of North Texas, Denton, Texas
| | - Erin C Schafer
- Department of Audiology & Speech-Language Pathology, University of North Texas, Denton, Texas
| | - Vincent Gracco
- Haskins Laboratories, Yale University, New Haven, Connecticut.,School of Communication Sciences & Disorders McGill University, Montreal, Canada
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Brown C, Gifford RH. Expansion of Audiologic Criteria for Pediatric Cochlear Implantation. Otolaryngol Clin North Am 2021; 54:1181-1191. [PMID: 34774230 DOI: 10.1016/j.otc.2021.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In 2020, the lower age limit for pediatric cochlear implant candidacy was lowered from 12 to 9 months of age. However, audiometric-based criteria for pediatric cochlear implant candidacy have remained unchanged for more than 20 years, requiring bilateral profound sensorineural hearing loss for children less than 2 years and bilateral severe-to-profound sensorineural hearing loss for children 2 years and older. Despite the static audiometric criteria, there is an increasing literature base demonstrating significant benefits for pediatric cochlear implant recipients who exceed current Food and Drug Administration-labeled indications for cochlear implantation.
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Affiliation(s)
- Christine Brown
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, 9302 MCE South Tower, Nashville, TN 37232, USA
| | - René H Gifford
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, 9302 MCE South Tower, Nashville, TN 37232, USA.
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17
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Relationships Between Daily Device Use and Early Communication Outcomes in Young Children With Cochlear Implants. Ear Hear 2021; 42:1042-1053. [PMID: 33974791 DOI: 10.1097/aud.0000000000000999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Children with significant hearing loss can gain access to sound via a cochlear implant (CI), but they must wear the device to reap the communication benefits of the device. That is, poor daily device use may result in underdeveloped perceptual and language skills in children and adolescents using CIs. This retrospective study focuses on the relationship between daily CI use and communication performance (auditory skills, speech recognition, expressive and receptive language) in young children, with the hypothesis that greater daily device use coincides with better communication outcomes. DESIGN The authors conducted a clinical chart review of patients with CIs younger than 5 years old who used at least 1 CI speech processor with datalogging technology. Participants (n = 65) had a mean chronologic age of 3.5 years, mean implantation age of 1.9 years, and mean device experience of 1.6 years. Approximately one quarter of participants had additional disabilities. Daily device use (i.e., datalogging information), child characteristics (e.g., age at CI), and assessments of communication skills (i.e., parent questionnaires, speech recognition tests, standardized language assessments) were obtained from each child's records. The investigators performed correlational analyses to examine relationships between communication outcomes and daily device use, and they employed group comparisons and correlations to identify child characteristics that were significantly associated with daily device use (p < 0.05, corrections for family-wise error). RESULTS Young children with CIs used their device, on average, 6.7 hr/d, with 63% below full-time use (<8 hr/d). Children without additional disabilities who wore their CI more hours per day had significantly better auditory, speech recognition, and language skills. A significant correlation also emerged between daily device use and early auditory skills in young CI users with additional disabilities, though relationships were more complicated for this subsample. Longer daily device use significantly correlated with younger age at CI and longer device experience. Differences in device use occurred in regards to absence versus presence of additional disabilities, bilateral versus unilateral device configuration, sign versus spoken language, and private versus government-assisted insurance. CONCLUSIONS The strong relationship between daily device use and early communication suggests clinicians and parents should focus on increasing the number of hours per day young children wear their CIs to enhance auditory and language outcomes. However, intervention strategies must consider barriers to consistent device use and goals of the family to efficiently and effectively support families of young children with CIs who struggle with inconsistent device use.
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18
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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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Gagnon EB, Eskridge H, Brown KD, Park LR. The Impact of Cumulative Cochlear Implant Wear Time on Spoken Language Outcomes at Age 3 Years. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:1369-1375. [PMID: 33784469 PMCID: PMC8608196 DOI: 10.1044/2020_jslhr-20-00567] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 05/29/2023]
Abstract
Purpose The purpose of this study was to analyze the impact of cumulative hearing hour percentage (HHP) on pediatric cochlear implant users' speech and language development at age 3 years and to determine an evidence-based wear time recommendation that yields typical spoken language standard scores. Method A retrospective chart review of 40 pediatric cochlear implant recipients was completed. Children met the following criteria: prelingually deafened, implanted at age 2 years or younger, utilized a speech processor with datalogging capabilities, a minimum of 1 year of cochlear implant use, and language testing completed at approximately age 3 years. Exclusion criteria included significant inner ear malformation (i.e., common cavity) or developmental delay that would preclude spoken language development. Results Multiple regression analysis revealed that age and implantation and HHP were predictive of spoken language skills at age 3 years. Further analysis yielded wear time recommendations associated with age-appropriate spoken language based on the age at implantation. Conclusions When the goal is age-appropriate spoken language, wear time recommendations should reflect a child's current age, age at implantation, and the comparative daily sound access of age-matched normal-hearing peers. The HHP measurement can help provide that information. The minimum wear time recommendation should be set to 80% HHP with the ultimate goal of 100% HHP to give pediatric cochlear implant recipients enough access to sound and language to achieve their spoken language goals.
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Affiliation(s)
- Erika B. Gagnon
- Department of Otolaryngology Head and Neck Surgery, The University of North Carolina at Chapel Hill
| | - Hannah Eskridge
- Department of Otolaryngology Head and Neck Surgery, The University of North Carolina at Chapel Hill
| | - Kevin D. Brown
- Department of Otolaryngology Head and Neck Surgery, The University of North Carolina at Chapel Hill
| | - Lisa R. Park
- Department of Otolaryngology Head and Neck Surgery, The University of North Carolina at Chapel Hill
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