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Box plots of the age at cochlear implantation (in months) in the early and late screened groups. The box plots represent the smallest observation, lower quartile, median (bold line), upper quartile, largest observation and outliers (1.5 times the interquartile range) (circles). The dotted horizontal lines represent the critical age at cochlear implantation (2 years). 14,18,19
Source publication
This study retrospectively evaluates the effect of newborn hearing screening on age at diagnosis, age at cochlear implantation and spoken language development in severely hearing-impaired children.
Age at diagnosis, age at cochlear implantation and language development were evaluated in a group of early screened (n = 149) and a group of late screen...
Contexts in source publication
Context 1
... in mind that the current study only included children who group received a cochlear implant over half a year later (mean = 2 years 6 months, SD = 1 year). A significant difference between the two groups was found for age at cochlear implantation (t(286) = 6.1, p<.001) (see Figure 2). ...
Context 2
... Several authors conclude that cochlear implantation should take place before the second birthday in order to optimise spoken language development. 14,18,19 The results of the current study show that, since the launch of newborn hearing screening, the average age at cochlear implantation (1 year 10 months) has fallen below that critical age of 2 years (see Figure 2), with a significant positive effect on spoken language development. ...
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Objective
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Methods
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Introduction: The infant-toddler meaningful auditory integration scale (IT-MAIS) can evaluate toddlers and infants’ early auditory development in aspects of detection, discrimination, and identification of sounds. The present study aims to evaluate the reliability and criterion validity of the Persian version of the IT-MAIS (IT-MAIS-P) for children...
Citations
... Early intervention with hearing aids (HAs) or cochlear implants (CIs) is widely known to have a significant positive effect on language development, which is related to many aspects of a child's everyday life [2]. Several studies have reported that the introduction of NHS has a considerable impact on lowering the average age of HL diagnosis and intervention [8][9][10][11]. Moreover, children with HL who were screened through the NHS demonstrated better outcomes in language and educational aspects than those who were not screened [9,11]. ...
... Several studies have reported that the introduction of NHS has a considerable impact on lowering the average age of HL diagnosis and intervention [8][9][10][11]. Moreover, children with HL who were screened through the NHS demonstrated better outcomes in language and educational aspects than those who were not screened [9,11]. ...
... For the present study, we used the hearing level classification of the World Health Organization (WHO 2020) as a reference. In babies who are HH or deaf, parents are given the option of early intervention for language/ interaction and hearing via HAs or CIs (Boons et al. 2013). Early CI fitting, before the age of 12 months, provides children who are HH or deaf the ability to develop sufficient speech perception and recognition to achieve nearly age-appropriate spoken language development (Colletti et al. 2011;Leigh et al. 2013;Dettman et al. 2016). ...
Objectives:
We aimed to determine whether children with severe hearing loss (HL) who use hearing aids (HAs) may experience added value in the perception of speech, language development, and executive function (EF) compared to children who are hard of hearing (HH) or children who are deaf and who use cochlear implants (CIs) and would benefit from CIs over HAs. The results contribute to the ongoing debate concerning CI criteria. We addressed the following research question to achieve this aim: Do children who are HH or deaf with CIs perform better than children with severe HL with HAs with respect to auditory speech perception, and receptive vocabulary and/or EF?
Design:
We compared two groups of children with severe HL, profound HL or deafness, with CIs or HAs, matched for gender, test age (range, 8 to 15 years), socioeconomic status, and nonverbal intelligence quotient. Forty-three children had CIs (pure-tone average at 2000 and 4000 Hz >85 dB HL), and 27 children had HAs (mean pure-tone average: 69 dB HL). We measured speech perception at the conversational level (65 dB SPL) and the soft speech perception level (45 dB SPL). We established receptive vocabulary using the Peabody Picture Vocabulary Test-III-NL. We tested EF using the Delis Kaplan Executive Function System battery and the Dutch Rey Auditory Verbal Learning Test. We employed the Mann-Whitney U test to compare data between the CI and HA groups. We used Chi-square goodness of fit tests to contrast the CI and HA group distributions with the norm data of children who are typically developing (TD). We harnessed Kendall's Tau-b to investigate relationships between the study variables.
Results:
Both groups of children, with CIs and Has, obtained ceiling scores for perception of speech on a conversational level. However, the HA group exhibited significantly lower perception on a soft speech level scores (68 %) than the CI group (87%). No difference was present between the receptive vocabulary distributions of the CI and HA groups. The median receptive vocabulary standard scores for both groups were well within the normal range (CI group: 93; HA group: 96). In addition, we did not find any difference in EF between the CI and HA groups. For planning and verbal memory, the distributions of observed scores for children with CIs were different from the expected distributions of children who are TD. In both groups, a large proportion of children obtained below-average scores for planning (CI: 44%; HA: 33%) and for long-term verbal memory (CI: 44%; HA: 35%). In the HA group, perception at a soft speech level was associated with receptive vocabulary and planning. In the CI group, we did not find any associations.
Conclusions:
Both groups of children with severe and profound HL with HAs exhibit less favorable auditory perception on the soft speech level, but not at a conversational level, compared to children who are HH or deaf with CIs. Both groups, children with CIs and HAs, only exhibit more problems in planning and verbal memory than the norm groups of children who are TD. The results indicate that to obtain age-appropriate levels of receptive vocabulary and EF, the perception at the soft speech level is a necessary but not sufficient prerequisite.
... La hipoacusia severa y profunda en etapa neonatal representa cerca de 1 por mil recién nacidos vivos en el mundo (Boons et al., 2013), generando en esta población una condición de discapacidad auditiva (DA) que constituye un desafío a abordar por los Estados a nivel de políticas públicas de salud, educación y sociales. El concepto DA ha evolucionado a lo largo de los años desde un modelo biomédico a uno biopsicosocial, lo cual inspira la Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud (CIF), aprobada por la OMS en 2001 (Jiménez, González, & Martín, 2002), que promueve la generación de políticas públicas integrales y coordinadas intersectorialmente en torno a la intervención e inclusión de las personas con DA. ...
La vinculación de políticas públicas y el trabajo intersectorial entre salud, educación y servicios sociales ha cobrado relevancia en el abordaje temprano y biopsicosocial en personas con discapacidad. En el campo de la discapacidad auditiva infantil, existirían controversias endicha vinculación debido alas discrepancias existentes entrela perspectiva clínica y sociocultural,referentesincluso alas modalidades deacceso al lenguaje para esta población. Este estudio de tipo cualitativoanalizaentrevistas semi-estructuradas buscandodescribir las percepciones de diferentes actores en País Vasco de España y Región Metropolitana de Chile. Fueron analizados 565 minutos de entrevistas de 27 participantes, a partir de 3 categorías emergentes: políticas y áreas existentes, intersectorialidad entre áreas, y servicio ofrecido por áreas. Los resultados muestran una percepción positiva sobre la vinculación política y trabajo intersectorial, pero persiste la preferencia del modelo biomédico y perspectiva clínica de la discapacidad por sobre el modelo biopsicosocial y el desarrollo de la perspectiva sociocultural. Esto ocurriría toda vez que el éxito se asocia al desarrollo normal a través de la adquisición de la lengua oral por sobre la diversidad de otras intervenciones en esta población. Las percepciones de los profesionales de las áreas estudiadas difieren en torno a los logros considerados como indicadores de éxito. Un centro coordinador de políticas y trabajo intersectorial, junto con la determinación de momentos de mayor relevancia de cada área en el proceso deatención podrían beneficiar el trabajo hacia este grupo.
... First of all, children with CIs receive implants at an early age, whereas children with ABIs generally receive implants at an older age (e.g., after first attempting a CI, after an extensive workup to determine the correct indication, or after treating another comorbidity that was considered a priority) (2). It is well known that early (<24 months of age) rather than late implantation provides better developmental outcomes (19)(20)(21). Second, the type of implant is different in design and placement. ...
Objectives: To evaluate long-term language development in children with prelingual deafness who received auditory brainstem implants (ABIs) compared with children who received cochlear implants (CIs) at the same hospital. Additional non-auditory disabilities were taken into account.
Study Design: Retrospective cohort study.
Setting: Tertiary referral center.
Patients: Ten children with bilateral malformations of the cochlea and/or cochlear nerve who received ABIs, including seven with additional disabilities, and 147 children with CIs as a reference group, including 22 children with additional disabilities.
Intervention: ABIs were implanted at 1.3 to 6.2 years of age. Follow-up ranged from 1.1 to 7.7 years.
Main Outcome Measures: Receptive and expressive language abilities were assessed using the Infant Toddler Meaningful Auditory Integration Scale (IT-MAIS), the Categories of Auditory Performance (CAP), the Meaningful Use of Speech Scale (MUSS), and the Speech Intelligibility Rate (SIR).
Results: Of the 10 children with ABIs, seven had long-term follow-up data. Within 1 year, six of the seven children with ABIs could identify sounds, respond to speech, and use their voice to attract attention. Language skills developed at a slower rate than in children with CIs and reached the same competence level when additional disabilities were absent. These language skills matched, on average, those of children with CIs with additional disabilities.
Conclusion: For deaf children with bilateral inner ear malformations, ABIs provide satisfactory auditory input. Children with ABIs are able to develop receptive and expressive language skills comparable to those of children with CIs with additional disabilities. Using this knowledge, preoperative parent counselling can be refined.
... Early audiological intervention provides remarkable benefits for hearing-impaired children, as early identified hearing-impaired children show better language outcomes, compared to late-identified children [10][11][12][13]. These benefits may include achieving language (receptive and expressive), speech, and vocabulary skills that fall within the normal limits for hearing peers. ...
Abstract Background Newborn hearing screening programs aim to lower the ages at audiological intervention among hearing-impaired children. In Wallonia and Brussels (Belgium), audiological intervention data are not collected in the screening program, and the ages at initiating audiological care have never been assessed. This study aimed to assess the evolution in the ages at initiating audiological intervention in the context of a newborn hearing screening program implementation. Methods This population-based descriptive study used data from the Belgian healthcare billing database. The main outcomes were the children’s ages at the initial audiological assessment, hearing-aid fitting, and cochlear implantation. Results were compared to the same outcomes from another Belgian regional program (Flanders) that was implemented one decade earlier. Annual birth cohorts from 2006 to 2011 were included in the study. Results In Wallonia-Brussels, the median ages for all outcomes tended to decrease over time but remained higher than in Flanders for each birth cohort. For all outcomes except the hearing-aid fitting, differences in median ages between the two regions became less pronounced during the study period. In 2006
... Both steps have proved beneficial for a child's speech, language, and socio-emotional development (Yoshinaga-Itano 2004;Korver et al. 2010), especially for children with severe-to-profound losses who received a CI at a young age. In fact, with early intervention and implantation, the speech and language skills of children with CI are almost comparable with those of hearing peers (Boons, Brokx, et al. 2013;Boons, De Raeve, et al. 2013). Because an improvement in language skills can benefit communicative abilities, early intervention for hearing loss can hold great potential for promoting a child's social development (Barker et al. 2009). ...
... To confirm the extensively studied positive effect of early identification and implantation on the language development of young DHH children (Yoshinaga-Itano 2004;Korver et al. 2010;Boons, Brokx, et al. 2013;Boons, De Raeve, et al. 2013), we were interested in the development of expressive language and language comprehension over time in our sample. A multilevel LMM with language comprehension as the dependent variable, time as the determinant for repeated measurement, and age, age at implantation, and time as the fixed effects revealed that younger age at implantation and longer duration of implant use increased language comprehension over time (t = ˗3.35; ...
... This study shows that early identification and intervention of hearing loss through CI results in better language skills, as previously established in other studies (Yoshinaga-Itano 2004;Boons, Brokx, et al. 2013;Boons, De Raeve, et al. 2013). The longitudinal design of this study uniquely adds insight into the protective effect of language skills on the development of early signs of psychopathology. ...
Objective:
Cochlear implants (CIs) have dramatically improved the lives of children who are deaf or hard of hearing; however, little is known about its implications for preventing the development of psychiatric symptoms in this at-risk population. This is the first longitudinal study to examine the early manifestation of emotional and behavioral disorders and associated risk and protective factors in early identified preschoolers with CIs compared with hearing peers.
Design:
Participants were 74 children with CIs and 190 hearing controls between ages 1 and 5 years (mean age, 3.8 years). Hearing loss was detected using the Newborn Hearing Screening in The Netherlands and Flanders. Parents completed the Early Childhood Inventory-4, a well-validated measure, to evaluate the symptoms of DSM-IV-defined psychiatric disorders, during three consecutive years. Language scores were derived from each child's medical notes.
Results:
Children with CIs and hearing controls evidenced comparable levels of disruptive behavior and anxiety/depression (which increased with age in both groups). Greater proficiency in language skills was associated with lower levels of psychopathology. Early CI and longer duration of CI use resulted in better language development. In turn, higher early language skills served as a protective factor against the development of disruptive behavior symptoms.
Conclusions:
This longitudinal study uniquely shows that improvement in language skills mitigates the development of early signs of psychopathology. Early identification of hearing loss and CIs help children improve their language skills.
... incelenmek amaçlandığında; yukarıdaki ilk cümlede yer alan iki kavramdan ("erken" ve "etkin") birbiri üzerine (ama özellikle birincinin ikinci üzerine) olan etkisinin irdelenmek istendiği anlaşılır ki yaklaşık yüzyıla uzanan bilgilerimiz her türlü engellilik alanında ve hatta engellilikten bağımsız olarak her türlü öğrenme ile ilişkili sürecin gelişiminde "ne kadar erken o kadar iyi", sayısız bilimsel araştırmayla desteklenmiş bir olgudur (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(16)(17)(18)(19)(20). İleri derecede DEÇİK olanlar arasından gereksinim duyanlara erken Kİ uygulamasının olumlu sonuçları da pek çok araştırmayla gösterilmiştir (21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Bu bağlamda bu derleme bu üç paragrafta özetlenip iki kelimeyle bağlanarak bitebilir: "çok olumlu". ...
... Ancak; yukarıdaki müspet bilgilere rağmen literatürde "erkenliğin etkinliğe etkisi hususunda farklı sonuçlar da yayınlamıştır; bu makalelerde tahmin edileceği üzere erkenliğin etkinliğe olumsuz etkisi değil, ama bahse konu olacak derecede net etkisinin olmadığı ifade edilmektedir (29)(30)(31)(32). Ayrıca gerek bu makalelerde gerekse yukarıda bahsedilen diğer araştırmalarda (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) başarıyı belirleyen bir dizi ön şart ve ön kabul ile yola çıkılan ve farklı değerlendirme araçlarından yararlanılan sonuçlar sunulmaktadır. ...
Newborn hearing screening programs (NHSP) are universally developed to provide longest period for the deaf people as much as possible for natural learning, language and speech via hearing. Cochlear Implant (CI) is a rehabilitative device used for bilateral severe or profound deafness, in which amplification by the hearing devices is not enough for learning, language and speech performances. In this paper, effects of NHSP on age of CI applications and performances of these children in the language, speech and other developmental areas, by giving particular attention to Turkish data.
Özet:
Yenidoğan işitme tarama programları (YDİTP); bütün dünyada işitme kayıplı bireye, doğal işitsel yolla öğrenme ve dolayısıyla da konuşma gelişimi olanağını en erken sürede kullanabilir olma şansı veren uygulamadır. Koklear İmplant (Kİ) ise, erken ya da geç, çocuk ya da erişkin, iki taraflı ileri-çok ileri işitme kayıplılarda işitme cihazıyla yeterli performansa elde edilemediğinde başvurulan en etkin işitsel (r)ehabiltiasyon yöntemidir. Bu yazıda YDİTP’nin Kİ uygulama yaşı ve çocuğun dil-konuşma ve diğer alanlardaki gelişimine etkisi ve bu süreçte etkili olan faktörler, Türkiye verileri de göz önünde bulundurularak incelenmiştir.
... These findings influence the policy of pediatric cochlear implantation in many countries and led to an increase in early and bilateral implantation (Peters, Wyss, & Manrique, 2010). Stimulated by the positive effects of early implantation and facilitated by universal newborn hearing screening, the average age at cochlear implantation in severely hearing impaired children has dropped rapidly over the last decade (Boons et al., 2013; Philips et al., 2009). Additionally, the growing scientific evidence regarding the benefits of bilateral implantation has led to a consensus statement in favor of early bilateral cochlear implantation (Ramsden et al., 2012). ...
Type is a wonderful tool to represent speech visually. Therefore, it can provide deaf individuals the information that they miss auditorily. Still, type does not represent all the information available in speech: it misses an exact indication of prosody. Prosody is the motor of expressive speech through speech variations in loudness, duration, and pitch. The speech of deaf readersis often less expressive because deafness impedes the perception and production of prosody. Support can be provided by visual cues that provide information about prosody—visual prosody—supporting both the training of speech variations and expressive reading. We will describe the influence of visual prosody on the reading expressiveness of deaf readers between age 7 and 18 (in this study, ‘deaf readers’ means persons with any kind of hearing loss, with or without hearing devices, who still developed legible speech). A total of seven cues visualize speech variations: a thicker/thinner font corresponds with a louder/quieter voice; a wider/narrower font relates to a lower/faster speed; a font raised above/lowered below the baseline suggests a higher/lower pitch; wider spaces between words suggest longer pauses. We evaluated the seven cues with questionnaires and a reading aloud test. Deaf readers relate most cues to the intendedspeech variation and read most of them aloud correctly. Only the raised cue is di#cult to connect to the intended speech variation at first, and a faster speed and lower pitch prove challenging to vocalize. Despite those two difficulties, this approach to visual prosody is elective in supporting speech prosody. The applied materials can form an example for typographers, type designers, graphic designers, teachers, speech therapists, and researchers developing expressive reading materials.
Objectives
Cochlear Implant (CI) is an established treatment for severe to profound hearing loss (HL). Early diagnosis and intervention in HL are crucial in order to provide access to sound and increase the likelihood of spoken language development in pre-lingually deaf children. In April 2011, the Health Service Executive (HSE) implemented the Universal Newborn Hearing Screening (UNHS) in a phased regional basis in Ireland. This study aimed to investigate the general clinical pathway for UNHS referrals to the CI service and to evaluate the impact of earlier referrals via UNHS on functional outcomes in children.
Methods
The first part of this study constituted a retrospective review of 100 children referred to the National Hearing Implant and Research Centre (NHIRC) via UNHS from November 2011 to December 2016.
Implanted children referred via UNHS were categorised into three groups according to their medical status. Their clinical pathway of cochlear implantation was evaluated. Functional outcomes were investigated based on medical and developmental status, respectively.
In the second part of this study, developmentally healthy implanted children referred post-UNHS were compared with the like referred pre-UNHS under the age of four, from January 2005 to June 2011. Current implant status of children, age at referral and functional outcomes were investigated.
Results
Medically healthy children were referred to the NHIRC at an earlier age than the medically complex children (2.8 months vs 5.2 months, p<0.01) and the children presenting with auditory neuropathy spectrum disorder (ANSD) (2.8 months vs 5.3 months, p<0.01). On average they attended their first appointment and were implanted at a younger age than the ANSD group (6.1 months vs 10.1 months, p<0.01; 16.3 months vs 29.4 months, p<0.001, respectively). Developmentally healthy children had significantly better functional outcomes than children with developmental delays.
Children referred via UNHS were referred and implanted at a younger age than those referred pre-UNHS. The former group achieved better CAP and SIR scores 2 years post-implantation.
Conclusion
UNHS in Ireland is an important platform for earlier diagnosis and management of congenital HL and our results show that early intervention has a positive impact on functional outcomes in children.
