Listening Difficulties of Children With Cochlear Implants in Mainstream Secondary Education

The impact of the COVID-19 pandemic on rehabilitation services provided for cochlear implant recipients in Saudi Arabia

OBJECTIVE

This study examines the impact of the COVID-19 pandemic on cochlear implantation (CI) recipients in Saudi Arabia. The impact was measured using the results of an online survey that investigated challenges related to access to re/habilitation and programming services, increased dependence on virtual interaction, and emotional impact.

METHODS

The cross-sectional online survey reached 353 pediatric and adult CI recipients between April 21st and May 3rd 2020, during the first weeks of implementing the lockdown strategy and the transitioning to virtual settings.

RESULTS

It was revealed that overall access to aural re/habilitation was considerably affected during the pandemic, and that the impact of this disruption was significantly greater for pediatric recipients than for adults. On the other hand, overall access to programming services was not affected. Results also revealed that CI recipients' performance at school or work was negatively impacted by the transition to a virtual communication. In addition, participants noticed a decline in their auditory performance, language skills, and speech understanding. They also registered feelings of anxiety, social isolation, and fear related to sudden changes in their CI function. Finally, the study revealed a gap between CI clinical/non-clinical support provided during the pandemic and the expectations of CI recipients.

CONCLUSION

Collectively, outcomes from this study highlight the importance of shifting towards a more patient -centered model that offers empowerment and self-advocacy. In addition, the outcomes also emphasize the importance of developing and adapting emergency protocols. This will ensure continuation of services provided to CI recipients during scenario disasters like a pandemic.Key messagesPediatric aural re/habilitation was subjected to a significantly greater interruption, compared to adult aural re/habilitation, duringthe COVID-19 shutdown.Cochlear Implant (CI) recipients expressed feelings of anxiety, social isolation, and fear. These feelings were related to sudden changes in their CI functioning, caused by interruption of support services during the pandemic.Patient -centered model can offer emergency protocols that ensure a smooth continuation of cochlear implant-related re/habilitation and services during disaster scenarios such as the COVID-19 pandemic.

Perspectives of D/HH-Students on Mainstream Higher Education: A Qualitative Study

Social, contextual, and technological changes affected the educational context for students who are deaf or hard of hearing (D/HH) in higher education in many countries. Although, several barriers to academic success already have been identified, the perspectives of D/HH-students on inclusion, educational facilities, and support are important to overcome them. This interview-based qualitative study describes the perspectives of 32 D/HH-students in mainstream higher education in The Netherlands. Within the dichotomy of environmental factors and personal factors, data have been analysed. Students experienced social acceptance by others with typical hearing, although participating in social events sometimes caused feelings of loneliness or separation. Access arrangements and adjustments in educational programs were necessary to cope with the experienced fatigue, participate during lectures or increase speech intelligibility of the lecturer. Especially poor classroom acoustics and limited intelligibility of speech hampered students during lectures. Students expressed their dissatisfaction about the way access arrangements and adjustments were arranged, yet at the same time, they do not know what the requested help should look like. A co-created policy in which D/HH-students, student support officers, and institutional policy makers are involved, would support D/HH-students in mainstream higher education in The Netherlands and abroad in their needs.

Clinical Practice Patterns of Fitting Advanced Device Features in Children With Cochlear Implants

PURPOSE

The purpose of this study was to identify common clinical practice patterns for providing advanced noise management features in children with cochlear implants (CIs) and evaluate trends in consideration of clinician experience and comfort with CI manufacturer-specific technology.

METHOD

A mixed-model survey including quantitative and qualitative questions regarding providing advanced noise management features in the pediatric CI population was collected electronically via research electronic data capture. Survey questions spanned approach/philosophy toward provision of features, age of provision, and demographics of respondents. Descriptive statistics were completed to define common clinical practice patterns and demographic information.

RESULTS

A total of 160 pediatric audiologists from 35 U.S. States and five Canadian provinces completed the survey. Most audiologists (73.8%) reported enabling automatic directional microphones, and a vast majority (91%) reported enabling advanced noise processing features such as automatic noise cancellers, wind noise cancellers, and impulse noise cancellers in recipients' main programs. Audiologists ranked features in terms of importance for a school-age child with the top three ranked as automatic noise reduction, automatic directional microphones, and concha-level microphones. Importance of child-specific factors varied depending upon the specific feature of interest.

CONCLUSIONS

Variability exists among providers in enabling advanced noise management features for pediatric CI recipients. Multiple factors, including patient characteristics, provider characteristics, and limited evidence-based guidance, could account for much of the variation. Overall, there is a trend toward automaticity for noise management. Additional studies are warranted to provide the evidence base for confidently programming advanced features for children using CIs.

Engagement of Children who are Deaf or Hard-of-Hearing Attending Mainstream Schools

This study compared the observed and the self-reported engagement of 16 students who are Deaf or hard-of-hearing (DHH) attending mainstream schools to that of matched controls with typical hearing. Observed engagement was measured through observations in the classroom setting using the Mainstream Version of the Code for Instructional Structure and Student Academic Reponses. Self-reported engagement was measured using the Classroom Participation Questionnaire. The results revealed no significant differences for either observed or self-reported engagement between the DHH and the control groups; however, three individual DHH participants had lower levels of observed engagement compared to their matched controls. As such, including engagement in the evaluation of students who are DHH may be important for some individuals to provide a better understanding of the daily challenges they experience at school. Where needs are identified, the support that students who are DHH receive should include a specific focus on engagement to assist with their successful inclusion.