Early prelingual auditory development and speech perception at 1-year follow-up in Mandarin-speaking children after cochlear implantation.
ABSTRACT 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.
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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. · 1.34 Impact Factor
- International journal of pediatric otorhinolaryngology 06/2013; · 0.85 Impact Factor
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ABSTRACT: Speech acquisition after cochlear implant is a long process. Various studies have followed the auditory milestones in the early period after implantation. The aim of the present study was to track the development of hearing skills in the early period after cochlear implantation and evaluate which factors influence the process. 195 records of children implanted in the Hadassah Medical Center were examined retrospectively. Data on etiology, age at implantation and type of implant were collected. In addition, information on the rate of progress was measured: the first time that there was detection and identification of Ling sounds, the first time it was possible to obtain SDT (speech detection threshold), SRT (speech reception threshold) and an audiogram, and the first accurate repetition of VCV (vowel consonant vowel) sounds. Results show a consistent pattern of auditory milestone acquisition similar to that of normal development, from milestones that do not require decoding beginning with SDT, detection of Ling sounds followed by an audiogram which requires cooperation, to tasks that involve decoding starting with SRT and repetition of Ling sounds and finally VCV repetition. The children implanted before 24 months of age achieved the auditory milestones later than children implanted between 2 and 6 years, apparently since these tasks involve cognitive abilities which are not yet developed in the youngest children. Previous hearing experience improved the rate of acquisition of the auditory milestones and progress was faster in the second implanted ear compared to the first implanted ear. More research is needed to address the relationship between acquisition of early auditory milestones and performance with the cochlear implant later on in life.International journal of pediatric otorhinolaryngology 09/2013; · 0.85 Impact Factor