The primary purpose of the current study was to evaluate early prelingual auditory development (EPLAD) and early speech perception longitudinally over the first year after cochlear implantation in Mandarin-speaking pediatric cochlear implant (CI) recipients. Outcome measures were designed to allow comparisons of outcomes with those of English-speaking pediatric CI recipients reported in previous research.
A hierarchical outcome assessment battery designed to measure EPLAD and early speech perception was used to evaluate 39 pediatric CI recipients implanted between the ages of 1 and 6 years at baseline and 3, 6, and 12 months after implantation. The battery consists of the Mandarin Infant-Toddler Meaningful Auditory Integration Scale (ITMAIS), the Mandarin Early Speech Perception (MESP) test, and the Mandarin Pediatric Speech Intelligibility (MPSI) test. The effects of age at implantation, duration of pre-implant hearing aid use, and Mandarin dialect exposure on performance were evaluated. EPLAD results were compared with the normal developmental trajectory and with results for English-speaking pediatric CI recipients. MESP and MPSI measures of early speech perception were compared with results for English-speaking recipients obtained with comparable measures.
EPLAD, as measured with the ITMAIS/MAIS, was comparable in Mandarin- and English-speaking pediatric CI recipients. Both groups exceeded the normal developmental trajectory when hearing age in CI recipients and chronological age in normal were equated. Evidence of significant EPLAD during pre-implant hearing aid use was observed; although at a more gradual rate than after implantation. Early development of speech perception, as measures with the MESP and MPSI tests, was also comparable for Mandarin- and English-speaking CI recipients throughout the first 12 months after implantation. Both Mandarin dialect exposure and the duration of pre-implant hearing aid use significantly affected measures of early speech perception during this time period.
EPLAD and early speech perception exhibited similar patterns of improvement during the first 12 months after early cochlear implantation. The duration of pre-implant hearing aid use had a significant positive effect on both categories of outcome measures. Consistent post-implant EPLAD trajectories and early speech perception results provide objective evidence that can guide best practices in early intervention protocols.
"For decades, the literature on speech, language, and communication outcomes following pediatric implantation in deaf children are extensive, and the resulting benefits in these fields have been confirmed in western as well as in Asian countries –. However, previous studies concerning the auditory performance of identifying daily ESs among children with CI are limited. "
[Show abstract][Hide abstract] ABSTRACT: The aims of this study were (1) to document the recognition performance of environmental sounds (ESs) in Mandarin-speaking children with cochlear implants (CIs) and to analyze the possible associated factors with the ESs recognition; (2) to examine the relationship between perception of ESs and receptive vocabulary level; and (3) to explore the acoustic factors relevant to perceptual outcomes of daily ESs in pediatric CI users. Forty-seven prelingually deafened children between ages 4 to 10 years participated in this study. They were divided into pre-school (group A: age 4-6) and school-age (group B: age 7 to 10) groups. Sound Effects Recognition Test (SERT) and the Chinese version of the revised Peabody Picture Vocabulary Test (PPVT-R) were used to assess the auditory perception ability. The average correct percentage of SERT was 61.2% in the preschool group and 72.3% in the older group. There was no significant difference between the two groups. The ESs recognition performance of children with CIs was poorer than that of their hearing peers (90% in average). No correlation existed between ESs recognition and receptive vocabulary comprehension. Two predictive factors: pre-implantation residual hearing and duration of CI usage were found to be associated with recognition performance of daily-encountered ESs. Acoustically, sounds with distinct temporal patterning were easier to identify for children with CIs. In conclusion, we have demonstrated that ESs recognition is not easy for children with CIs and a low correlation existed between linguistic sounds and ESs recognition in these subjects. Recognition ability of ESs in children with CIs can only be achieved by natural exposure to daily-encountered auditory stimuli if sounds other than speech stimuli were less emphasized in routine verbal/oral habilitation program. Therefore, task-specific measures other than speech materials can be helpful to capture the full profile of auditory perceptual progress after implantation.
PLoS ONE 06/2013; 8(6):e66100. DOI:10.1371/journal.pone.0066100 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Abstract Objective: Perform longitudinal evaluations of young children during the first 12 months after initial hearing-aid fitting. Document evidence of early prelingual auditory development (EPLAD), identify factors that affect EPLAD, and define performance milestones that can guide best practices. Design: Unblinded, prospective, within-subject, repeated-measures design. Audiological measures and measures of EPLAD were taken at baseline, 3, 6, and 12 months after hearing-aid fitting. Study sample: Subjects were 45 pediatric patients initially fitted with hearing aids between 1 and 5.5 years of age. Four groups were formed for analysis purposes based on severity of hearing loss (moderate-to-severe and profound) and initial fitting age (≤ 30 months and > 30 months). Results: All groups exhibited statistically significant increases in EPLAD within six months of hearing-aid fitting, and those with profound losses exhibited further statistically significant improvement between six and 12 months. Similar EPLAD levels were reached at 12 months regardless of severity of hearing loss. The EPLAD trajectory is similar to that following early cochlear implantation. Conclusions: Measures of EPLAD provide a means of evaluating outcomes following early pediatric hearing-aid intervention, supplementing behavioral audiological measures.
International journal of audiology 08/2012; 51(11):846-55. DOI:10.3109/14992027.2012.711914 · 1.84 Impact Factor
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