1
|
Humphries T, Mathur G, Napoli DJ, Rathmann C. An approach designed to fail deaf children and their parents and how to change it. Harm Reduct J 2024; 21:132. [PMID: 38987778 PMCID: PMC11238372 DOI: 10.1186/s12954-024-01039-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 06/14/2024] [Indexed: 07/12/2024] Open
Abstract
The matter of raising and educating deaf children has been caught up in percepts of development that are persistently inaccurate and at odds with scientific research. These percepts have negatively impacted the health and quality of life of deaf children and deaf people in general. The all too prevalent advice is to raise the child strictly orally and wait to see what happens. Only when the child is seriously behind is a completely accessible language - a sign language - introduced, and that is far too late for protecting cognitive health. The medical profession, along with others, needs to offer parents better advice and better supports so that neither the children nor their parents wait and watch as the oral-only method fails. All must take responsible action to assure an approach that succeeds.
Collapse
Affiliation(s)
- Tom Humphries
- Department of Communication, University of California at San Diego, La Jolla, CA, 92093, USA
| | - Gaurav Mathur
- Department of Linguistics, Gallaudet University, Washington, DC, 20002, USA
| | - Donna Jo Napoli
- Department of Linguistics, Swarthmore College, Swarthmore, PA, 19081, USA.
| | - Christian Rathmann
- Department of Deaf Studies and Sign Language Interpreting, Humboldt- Universität zu Berlin, Berlin, Germany
| |
Collapse
|
2
|
Lima JVDS, de Morais CFM, Zamberlan-Amorim NE, Mandrá PP, Reis ACMB. Neurocognitive function in children with cochlear implants and hearing aids: a systematic review. Front Neurosci 2023; 17:1242949. [PMID: 37859761 PMCID: PMC10582571 DOI: 10.3389/fnins.2023.1242949] [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: 06/20/2023] [Accepted: 09/15/2023] [Indexed: 10/21/2023] Open
Abstract
Purpose To systematically review the existing literature that examines the relationship between cognition, hearing, and language in children using cochlear implants and hearing aids. Method The review has been registered in Prospero (Registration: CRD 42020203974). The review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis and examined the scientific literature in VHL, MEDLINE, CINAHL, Scopus, WOS, and Embase. It included original observational studies in children using hearing aids and/or cochlear implants who underwent cognitive and auditory and/or language tests. Data were extracted from the studies and their level of evidence was graded with the Oxford Center for Evidence-Based Medicine: Levels of Evidence. Meta-analysis could not be performed due to data heterogeneity. Outcomes are described in narrative and tables synthesis. Results The systematic search and subsequent full-text evaluation identified 21 studies, conducted in 10 different countries. Altogether, their samples comprised 1,098 individuals, aged 0.16-12.6 years. The studies assessed the following cognitive domains: memory, nonverbal cognition, reasoning, attention, executive functions, language, perceptual-motor function, visuoconstructive ability, processing speed, and phonological processing/phonological memory. Children with hearing loss using cochlear implants and hearing aids scored significantly lower in many cognitive functions than normal hearing (NH) children. Neurocognitive functions were correlated with hearing and language outcomes. Conclusion Many cognitive tools were used to assess cognitive function in children with hearing devices. Results suggest that children with cochlear implants and hearing aids have cognitive deficits; these outcomes are mainly correlated with vocabulary. This study highlights the need to understand children's cognitive function and increase the knowledge of the relationship between cognition, language, and hearing in children using cochlear implants and hearing aids.
Collapse
Affiliation(s)
- Jefferson Vilela da Silva Lima
- Postgraduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Caroline Favaretto Martins de Morais
- Postgraduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Nelma Ellen Zamberlan-Amorim
- Clinics Hospital of the Ribeirão Preto Medical School (HCFMRP-USP), University of São Paulo, Ribeirão Preto, Brazil
| | - Patricia Pupin Mandrá
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | |
Collapse
|
3
|
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.
Collapse
Affiliation(s)
| | | | | | - Gary Morgan
- City, University of London, UK; Universitat Oberta de Catalunya.
| |
Collapse
|
4
|
Terhune-Cotter BP, Conway CM, Dye MWG. Visual Sequence Repetition Learning is Not Impaired in Signing DHH Children. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2021; 26:322-335. [PMID: 34017994 DOI: 10.1093/deafed/enab007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 06/12/2023]
Abstract
The auditory scaffolding hypothesis states that early experience with sound underpins the development of domain-general sequence processing abilities, supported by studies observing impaired sequence processing in deaf or hard-of-hearing (DHH) children. To test this hypothesis, we administered a sequence processing task to 77 DHH children who use American Sign Language (ASL) and 23 hearing monolingual children aged 7-12 years and found no performance difference between them after controlling for age and nonverbal intelligence. Additionally, neither spoken language comprehension scores nor hearing loss levels predicted sequence processing scores in the DHH group, whereas ASL comprehension scores did. Our results do not indicate sequence processing deficits in DHH children and do not support the auditory scaffolding hypothesis; instead, these findings suggest that factors related to experience with and/or proficiency in an accessible language during development may be more important determinants of sequence processing abilities.
Collapse
Affiliation(s)
| | | | - Matthew W G Dye
- Rochester Institute of Technology, Rochester, NY, United States of America
| |
Collapse
|
5
|
How statistical learning interacts with the socioeconomic environment to shape children's language development. PLoS One 2021; 16:e0244954. [PMID: 33481800 PMCID: PMC7822340 DOI: 10.1371/journal.pone.0244954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 12/18/2020] [Indexed: 11/29/2022] Open
Abstract
Language is acquired in part through statistical learning abilities that encode environmental regularities. Language development is also heavily influenced by social environmental factors such as socioeconomic status. However, it is unknown to what extent statistical learning interacts with SES to affect language outcomes. We measured event-related potentials in 26 children aged 8–12 while they performed a visual statistical learning task. Regression analyses indicated that children’s learning performance moderated the relationship between socioeconomic status and both syntactic and vocabulary language comprehension scores. For children demonstrating high learning, socioeconomic status had a weaker effect on language compared to children showing low learning. These results suggest that high statistical learning ability can provide a buffer against the disadvantages associated with being raised in a lower socioeconomic status household.
Collapse
|
6
|
Letter to the Editor: Do Pediatric Cochlear Implant Recipients Display Domain-General Sequencing Difficulties? A Comment on. Ear Hear 2020; 41:1051-1054. [PMID: 32358327 DOI: 10.1097/aud.0000000000000841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
7
|
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.
Collapse
Affiliation(s)
| | | | | | | | | | - Brent Spehar
- Washington University School of Medicine, St. Louis, MO, USA
| |
Collapse
|
8
|
Gremp MA, Deocampo JA, Walk AM, Conway CM. Visual sequential processing and language ability in children who are deaf or hard of hearing. JOURNAL OF CHILD LANGUAGE 2019; 46:785-799. [PMID: 30803455 PMCID: PMC6633907 DOI: 10.1017/s0305000918000569] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study investigated the role of sequential processing in spoken language outcomes for children who are deaf or hard of hearing (DHH), ages 5;3-11;4, by comparing them to children with typical hearing (TH), ages 6;3-9;7, on sequential learning and memory tasks involving easily nameable and difficult-to-name visual stimuli. Children who are DHH performed more poorly on easily nameable sequencing tasks, which positively predicted receptive vocabulary scores. Results suggest sequential learning and memory may underlie delayed language skills of many children who are DHH. Implications for language development in children who are DHH are discussed.
Collapse
|
9
|
Nonverbal Visual Sequential Learning in Children With Cochlear Implants: Preliminary Findings. Ear Hear 2019; 40:213-217. [PMID: 29547477 DOI: 10.1097/aud.0000000000000564] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The authors tested the hypothesis that children with cochlear implants (CIs) experience domain-general deficits in sequential learning. Twenty children with CIs and 40 children with normal hearing (NH) participated. Participants completed a serial reaction time task that measured implicit sequential learning. During random sequence phases, the CI group had significantly slower reaction times than the NH group. However, there were no significant differences in the rates of sequential learning between groups. Age at implantation was not significantly associated with learning rate in the CI group. Children with CIs demonstrated nonverbal sequential learning that is comparable to children with NH. Contrary to previous research, early auditory deprivation may not be associated with deficits in domain-general sequential learning, but may affect sequential processing. Further investigation is needed to understand the mechanisms underlying the overall delayed reaction times of children with CIs.
Collapse
|
10
|
Deocampo JA, Smith GNL, Kronenberger WG, Pisoni DB, Conway CM. The Role of Statistical Learning in Understanding and Treating Spoken Language Outcomes in Deaf Children With Cochlear Implants. Lang Speech Hear Serv Sch 2019; 49:723-739. [PMID: 30120449 DOI: 10.1044/2018_lshss-stlt1-17-0138] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/11/2018] [Indexed: 11/09/2022] Open
Abstract
Purpose Statistical learning-the ability to learn patterns in environmental input-is increasingly recognized as a foundational mechanism necessary for the successful acquisition of spoken language. Spoken language is a complex, serially presented signal that contains embedded statistical relations among linguistic units, such as phonemes, morphemes, and words, which represent the phonotactic and syntactic rules of language. In this review article, we first review recent work that demonstrates that, in typical language development, individuals who display better nonlinguistic statistical learning abilities also show better performance on different measures of language. We next review research findings that suggest that children who are deaf and use cochlear implants may have difficulties learning sequential input patterns, possibly due to auditory and/or linguistic deprivation early in development, and that the children who show better sequence learning abilities also display improved spoken language outcomes. Finally, we present recent findings suggesting that it may be possible to improve core statistical learning abilities with specialized training and interventions and that such improvements can potentially impact and facilitate the acquisition and processing of spoken language. Method We conducted a literature search through various online databases including PsychINFO and PubMed, as well as including relevant review articles gleaned from the reference sections of other review articles used in this review. Search terms included various combinations of the following: sequential learning, sequence learning, statistical learning, sequence processing, procedural learning, procedural memory, implicit learning, language, computerized training, working memory training, statistical learning training, deaf, deafness, hearing impairment, hearing impaired, DHH, hard of hearing, cochlear implant(s), hearing aid(s), and auditory deprivation. To keep this review concise and clear, we limited inclusion to the foundational and most recent (2005-2018) relevant studies that explicitly included research or theoretical perspectives on statistical or sequential learning. We here summarize and synthesize the most recent and relevant literature to understanding and treating language delays in children using cochlear implants through the lens of statistical learning. Conclusions We suggest that understanding how statistical learning contributes to spoken language development is important for understanding some of the difficulties that children who are deaf and use cochlear implants might face and argue that it may be beneficial to develop novel language interventions that focus specifically on improving core foundational statistical learning skills.
Collapse
Affiliation(s)
| | - Gretchen N L Smith
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis
| | - William G Kronenberger
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis.,Department of Psychiatry, Indiana University School of Medicine, Indianapolis
| | - David B Pisoni
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis.,Department of Psychological and Brain Sciences, Indiana University,Bloomington
| | - Christopher M Conway
- Department of Psychology, Georgia State University, Atlanta.,The Neuroscience Institute, Georgia State University, Atlanta
| |
Collapse
|
11
|
Giustolisi B, Emmorey K. Visual Statistical Learning With Stimuli Presented Sequentially Across Space and Time in Deaf and Hearing Adults. Cogn Sci 2018; 42:3177-3190. [PMID: 30320454 DOI: 10.1111/cogs.12691] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 09/05/2018] [Accepted: 09/10/2018] [Indexed: 11/27/2022]
Abstract
This study investigated visual statistical learning (VSL) in 24 deaf signers and 24 hearing non-signers. Previous research with hearing individuals suggests that SL mechanisms support literacy. Our first goal was to assess whether VSL was associated with reading ability in deaf individuals, and whether this relation was sustained by a link between VSL and sign language skill. Our second goal was to test the Auditory Scaffolding Hypothesis, which makes the prediction that deaf people should be impaired in sequential processing tasks. For the VSL task, we adopted a modified version of the triplet learning paradigm, with stimuli presented sequentially across space and time. Results revealed that measures of sign language skill (sentence comprehension/repetition) did not correlate with VSL scores, possibly due to the sequential nature of our VSL task. Reading comprehension scores (PIAT-R) were a significant predictor of VSL accuracy in hearing but not deaf people. This finding might be due to the sequential nature of the VSL task and to a less salient role of the sequential orthography-to-phonology mapping in deaf readers compared to hearing readers. The two groups did not differ in VSL scores. However, when reading ability was taken into account, VSL scores were higher for the deaf group than the hearing group. Overall, this evidence is inconsistent with the Auditory Scaffolding Hypothesis, suggesting that humans can develop efficient sequencing abilities even in the absence of sound.
Collapse
Affiliation(s)
| | - Karen Emmorey
- School of Speech, Language and Hearing Sciences, San Diego State University
| |
Collapse
|
12
|
Hall ML, Eigsti IM, Bortfeld H, Lillo-Martin D. Executive Function in Deaf Children: Auditory Access and Language Access. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1970-1988. [PMID: 30073268 PMCID: PMC6198917 DOI: 10.1044/2018_jslhr-l-17-0281] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 12/28/2017] [Accepted: 04/17/2018] [Indexed: 05/04/2023]
Abstract
Purpose Deaf children are frequently reported to be at risk for difficulties in executive function (EF); however, the literature is divided over whether these difficulties are the result of deafness itself or of delays/deficits in language that often co-occur with deafness. The purpose of this study is to discriminate these hypotheses by assessing EF in populations where the 2 accounts make contrasting predictions. Method We use a between-groups design involving 116 children, ages 5-12 years, across 3 groups: (a) participants with normal hearing (n = 45), (b) deaf native signers who had access to American Sign Language from birth (n = 45), and (c) oral cochlear implant users who did not have full access to language prior to cochlear implantation (n = 26). Measures include both parent report and performance-based assessments of EF. Results Parent report results suggest that early access to language has a stronger impact on EF than early access to sound. Performance-based results trended in a similar direction, but no between-group differences were significant. Conclusions These results indicate that healthy EF skills do not require audition and therefore that difficulties in this domain do not result primarily from a lack of auditory experience. Instead, results are consistent with the hypothesis that language proficiency, whether in sign or speech, is crucial for the development of healthy EF. Further research is needed to test whether sign language proficiency also confers benefits to deaf children from hearing families.
Collapse
Affiliation(s)
- Matthew L. Hall
- Department of Psychology, University of Massachusetts Dartmouth
- Department of Linguistics, University of Connecticut, Storrs
| | | | - Heather Bortfeld
- Department of Psychological Sciences, University of California, Merced
| | | |
Collapse
|
13
|
Torkildsen JVK, Arciuli J, Haukedal CL, Wie OB. Does a lack of auditory experience affect sequential learning? Cognition 2018; 170:123-129. [PMID: 28988151 DOI: 10.1016/j.cognition.2017.09.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 09/04/2017] [Accepted: 09/27/2017] [Indexed: 11/25/2022]
|
14
|
Hall ML, Eigsti IM, Bortfeld H, Lillo-Martin D. Auditory Deprivation Does Not Impair Executive Function, But Language Deprivation Might: Evidence From a Parent-Report Measure in Deaf Native Signing Children. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2017; 22:9-21. [PMID: 27624307 PMCID: PMC5189172 DOI: 10.1093/deafed/enw054] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 07/18/2016] [Accepted: 08/16/2016] [Indexed: 05/14/2023]
Abstract
Deaf children are often described as having difficulty with executive function (EF), often manifesting in behavioral problems. Some researchers view these problems as a consequence of auditory deprivation; however, the behavioral problems observed in previous studies may not be due to deafness but to some other factor, such as lack of early language exposure. Here, we distinguish these accounts by using the BRIEF EF parent report questionnaire to test for behavioral problems in a group of Deaf children from Deaf families, who have a history of auditory but not language deprivation. For these children, the auditory deprivation hypothesis predicts behavioral impairments; the language deprivation hypothesis predicts no group differences in behavioral control. Results indicated that scores among the Deaf native signers (n = 42) were age-appropriate and similar to scores among the typically developing hearing sample (n = 45). These findings are most consistent with the language deprivation hypothesis, and provide a foundation for continued research on outcomes of children with early exposure to sign language.
Collapse
|
15
|
Kral A, Kronenberger WG, Pisoni DB, O'Donoghue GM. Neurocognitive factors in sensory restoration of early deafness: a connectome model. Lancet Neurol 2016; 15:610-21. [PMID: 26976647 PMCID: PMC6260790 DOI: 10.1016/s1474-4422(16)00034-x] [Citation(s) in RCA: 200] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 12/15/2015] [Accepted: 01/21/2016] [Indexed: 12/11/2022]
Abstract
Progress in biomedical technology (cochlear, vestibular, and retinal implants) has led to remarkable success in neurosensory restoration, particularly in the auditory system. However, outcomes vary considerably, even after accounting for comorbidity-for example, after cochlear implantation, some deaf children develop spoken language skills approaching those of their hearing peers, whereas other children fail to do so. Here, we review evidence that auditory deprivation has widespread effects on brain development, affecting the capacity to process information beyond the auditory system. After sensory loss and deafness, the brain's effective connectivity is altered within the auditory system, between sensory systems, and between the auditory system and centres serving higher order neurocognitive functions. As a result, congenital sensory loss could be thought of as a connectome disease, with interindividual variability in the brain's adaptation to sensory loss underpinning much of the observed variation in outcome of cochlear implantation. Different executive functions, sequential processing, and concept formation are at particular risk in deaf children. A battery of clinical tests can allow early identification of neurocognitive risk factors. Intervention strategies that address these impairments with a personalised approach, taking interindividual variations into account, will further improve outcomes.
Collapse
Affiliation(s)
- Andrej Kral
- Institute of AudioNeuroTechnology and Department of Experimental Otology, ENT Clinics, Medical University Hannover, Hannover, Germany; School of Behavioural and Brain Sciences, The University of Texas at Dallas, Dallas, TX, USA.
| | - William G Kronenberger
- Department of Psychiatry, and DeVault Otologic Research Laboratory, Department of Otolaryngology: Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Psychological and Brain Sciences, Indiana University, Indianapolis, IN, USA
| | - David B Pisoni
- Department of Psychiatry, and DeVault Otologic Research Laboratory, Department of Otolaryngology: Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Psychological and Brain Sciences, Indiana University, Indianapolis, IN, USA
| | - Gerard M O'Donoghue
- National Institute of Health Research, Nottingham Hearing Biomedical Research Unit, Nottingham University Hospitals NHS Trust, Nottingham, UK
| |
Collapse
|