Early prelingual auditory development and speech perception at 1-year follow-up in Mandarin-speaking children after cochlear implantation

ArticleinInternational journal of pediatric otorhinolaryngology 75(11):1418-26 · September 2011with76 Reads
DOI: 10.1016/j.ijporl.2011.08.005 · Source: PubMed
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.
    • "(EPLAD) and early speech perception outcomes over the first year of use of hearing aids or cochlear implants (Zheng et al., 2011; Zheng et al., 2012). Another group of researchers reported speech perception skills for CI children in the northern part of China who were not exposed to southern dialects, but only Mandarin (Chen, Wong, Zhu, & Xi, 2015Mandarin is a tonal language. "
    [Show abstract] [Hide abstract] ABSTRACT: Since the 1970s, outcome studies for children with hearing loss expanded from focusing on assessing auditory awareness and speech perception skills to evaluating language and speech development. Since the early 2000s, the multi-center large scale research systematically studied outcomes in the areas of auditory awareness, speech-perception, language development, speech development, educational achievements, cognitive development, and psychosocial development. These studies advocated the establishment of baseline and regular follow-up evaluations with a comprehensive framework centered on language development. Recent research interests also include understanding the vast differences in outcomes for children with hearing loss, understanding the relationships between neurocognitive development and language acquisition in children with hearing loss, and using outcome studies to guide evidence-based clinical practice. After the establishment of standardized Mandarin language assessments, outcomes research in Mainland China has the potential to expand beyond auditory awareness and speech perception studies.
    Full-text · Article · May 2016
    • "Consistent with the criterion used in Zheng et al. (2011), data from participants who attended at least three test intervals were included in the data analysis. As a result, a different number of subjects were assessed at each test interval: 80 at baseline, 75 at 3 months, 72 at 6 months and 62 at 12 months after CI activation. "
    [Show abstract] [Hide abstract] ABSTRACT: To investigate the development of early auditory capability and speech perception in the prelingual deaf children after cochlear implantation, and to study the feasibility of currently available Chinese assessment instruments for the evaluation of early auditory skill and speech perception in hearing-impaired children. A total of 83 children with severe-to-profound prelingual hearing impairment participated in this study. Participants were divided into four groups according to the age for surgery: A (1-2 years), B (2-3 years), C (3-4 years) and D (4-5 years). The auditory skill and speech perception ability of CI children were evaluated by trained audiologists using the infant-toddler/meaningful auditory integration scale (IT-MAIS/MAIS) questionnaire, the Mandarin Early Speech Perception (MESP) test and the Mandarin Pediatric Speech Intelligibility (MPSI) test. The questionnaires were used in face to face interviews with the parents or guardians. Each child was assessed before the operation and 3 months, 6 months, 12 months after switch-on. After cochlear implantation, early postoperative auditory development and speech perception gradually improved. All MAIS/IT-MAIS scores showed a similar increasing trend with the rehabilitation duration (F=5.743, P=0.007). Preoperative and post operative MAIS/IT-MAIS scores of children in age group C (3-4 years) was higher than that of other groups. Children who had longer hearing aid experience before operation demonstrated higher MAIS/IT-MAIS scores than those with little or no hearing aid experience (F=4.947, P=0.000). The MESP test showed that, children were not able to perceive speech as well as detecting speech signals. However as the duration of CI use increased, speech perception ability also improved substantially. However, only about 40% of the subjects could be evaluated using the most difficult subtest on the MPSI in quiet at 12 months after switch-on. As MCR decreased, the proportion of children who could be tested using the MPSI reduced. Within one year after CI, children develop early auditory and speech perception capabilities with time. Chinese versions of the IT-MAIS/MAIS, MESP and MPSI are useful instruments to document early auditory and speech perception skills in children after CI implantation.
    Article · Apr 2015
    • "Very few studies have reported on the ability of preschool implantees in Mainland China to perceive sentence in noise. Using the Mandarin Pediatric Sentence Intelligibility (MPSI) test [27], Zheng et al. [28] described sentence perception both in quiet and in noise during the first year of CI use in Mandarin-speaking children and found that with a longer duration of CI use, increasingly more children could be tested with the MPSI. However, only one third of the children in that study could be tested with the MPSI after 12 months of CI use. "
    [Show abstract] [Hide abstract] ABSTRACT: Objectives: The purpose of this study was to examine the outcomes of cochlear implantation in young children in terms of (1) perception of lexical tones in quiet, (2) perception of sentences in quiet and in noise, (3) the effects of five demographic variables (i.e., preoperative hearing level, age at implantation, duration of cochlear implants use, maternal educational level, and whether a child underwent a hearing aid trial before implantation) on lexical tone perception and sentence perception, and (4) the relationship between lexical tone perception and sentence perception. Methods: 96 participants, aged from 2.41 years to 7.09 years, were recruited in mainland China. The children exhibited normal cognitive abilities and received unilateral implants at an average age of 2.72 years, with ages ranging from 0.69 to 5 years of age. Results: The mean score for tone identification was 77% (SD=13%; chance level=50%). Tone 2/tone 3 was the most difficult tone contrast to identify. Children with a longer duration of CI use and whose mothers had more years of education tended to perform better in sentence perception in quiet and in noise. Having undergone a hearing aid trial before implantation and more residual hearing were additional factors contributing to better sentence perception in noise. The only demographical variable that related to tone perception in quiet was duration of CI. In addition, while there was a modest correlation between tone perception and sentence perception in quiet (rs=0.47, p<0.001), the correlation between tone perception in quiet and sentence perception in noise was much weaker (rs=-0.28, p<0.05). Conclusions: The findings suggested that most young children who had been implanted before 5 years of age and had 1-3 years of implant use did not catch up with their aged peers with normal hearing in tone perception and sentence perception. The weak to moderate correlation between tone perception in quiet and sentence perception might imply that the improvement of tone perception in quiet may not necessarily contribute to sentence perception, especially in noise condition.
    Full-text · Article · Aug 2014
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