A comparison of the consonant production between Dutch children using cochlear implants and children using hearing aids

Objectives

The main purpose of the present study was to compare the consonant error patterns of Dutch prelingually deaf CI children with prelingually hearing-impaired hearing aid (HA) children. The authors hypothesized that subjects using conventional hearing aids would have poorer consonant production skills. Additionally, the impact of the age at implantation (CI) and the degree of hearing loss (HA) was determined.

Methodology

This is a comparative study of 29 prelingually deaf CI children (m.a. 9;0 y) and 32 prelingually hearing-impaired HA children (m.a. 9;11 y) who received their first hearing aid before the age of 2 years. Nineteen CI children were implanted before the age of 5 years. Nine HA children had thresholds above 90 dB (range: 91-105 dB), 15 between 70 and 90 dB (range: 72-90 dB) and 8 below 70 dB (range: 58-68 dB). Speech samples of all the children were elicited by means of a picture naming test and were video-recorded for further phonetic and phonological analysis.

Results

Considerably more phonetic and phonologic errors were observed in the HA children with thresholds above 70 dB (range: 72-105 dB). No notable differences could be found between deaf CI children and HA children with thresholds below 70 dB. Even children implanted after the age of 5 years showed significantly fewer phonetic and phonological errors than HA children.

Conclusion

The consonant production of implanted children is more adequate than the consonant production of HA children with a hearing loss of 70 dB or more. In addition, the results also indicate that even after the age of 5 years, implantation can still have an advantageous effect on a child's consonant production.     

A comparison of the perceptual evaluation of speech production between bilaterally implanted children, unilaterally implanted children, children using hearing aids, and normal-hearing children

OBJECTIVE: The purpose of this study was to compare the perceptual evaluation of several speech characteristics between bilaterally implanted children (biCI), unilaterally implanted children (uniCI), children using hearing aids (HA), and normal-hearing children (NH). Design: Perceptual evaluations of intelligibility, phonation, resonance, and articulation were compared between the several subgroups. Study sample: Thirteen biCI children, 14 uniCI children, 10 HA children using hearing aids and 11 NH children participated. Results:The biCI children did not show statistically significant differences with the NH children for overall intelligibility, phonation, and resonance. Yet, significantly more distortions and consonant cluster reductions were observed in the biCI children compared with the NH children. In comparison with the uniCI and HA children, the NH as well as the biCI children obtained better evaluations for intelligibility, phonation, resonance, and articulation of consonants. CONCLUSIONS: The results of this study demonstrated a possible additional beneficial effect of bilateral implantation on several speech characteristics of prelingually deaf children and as a consequence highlighted the interest of further research.     

Comparison of the overall intelligibility,articulation, resonance,and voice characteristics between children using cochlear implants and those using bilateral hearing aids: A pilot study

The purpose of this study was to determine and to compare the overall intelligibility, articulation, resonance, and voice characteristics in children using cochlear implants (CI) and children using conventional hearing aids (HA). Nine prelingually deaf children using CI and six children with a prelingual severe hearing loss using HA, were selected to participate. Objective (DSI, nasalance scores) as well as subjective assessment techniques (perceptual evaluations) were used. Both the CI and HA children demonstrated normal vocal quality and resonance but showed the presence of articulation disorders. In the CI children, intelligibility was significantly better compared to the HA children. Significantly more phonetic and phonological disorders were present in the HA children. The results of this study show a poorer intelligibility of the HA children in comparison with the CI children which is probably due to the occurrence of significantly more phonetic and phonological disorders. Future detailed analysis in a larger sample of CI and HA children may help further clarify the issue of speech and voice characteristics and may demonstrate an important prognostic value.     

Comparison of the overall intelligibility, articulation, resonance, and voice characteristics between children using cochlear implants and those using bilateral hearing aids: a pilot study

The purpose of this study was to determine and to compare the overall intelligibility, articulation, resonance, and voice characteristics in children using cochlear implants (CI) and children using conventional hearing aids (HA). Nine prelingually deaf children using CI and six children with a prelingual severe hearing loss using HA, were selected to participate. Objective (DSI, nasalance scores) as well as subjective assessment techniques (perceptual evaluations) were used. Both the CI and HA children demonstrated normal vocal quality and resonance but showed the presence of articulation disorders. In the CI children, intelligibility was significantly better compared to the HA children. Significantly more phonetic and phonological disorders were present in the HA children. The results of this study show a poorer intelligibility of the HA children in comparison with the CI children which is probably due to the occurrence of significantly more phonetic and phonological disorders. Future detailed analysis in a larger sample of CI and HA children may help further clarify the issue of speech and voice characteristics and may demonstrate an important prognostic value.     

Speech production intelligibility of early implanted pediatric cochlear implant users

Objectives

To investigate the influence of age, and age-at-implantation, on speech production intelligibility in prelingually deaf pediatric cochlear implant recipients.

Methods

Forty prelingually, profoundly deaf children who received cochlear implants between 8 and 40 months of age. Their age at testing ranged between 2.5 and 18 years. Children were recorded repeating the 10 sentences in the Beginner's Intelligibility Test. These recordings were played back to normal-hearing listeners who were unfamiliar with deaf speech and who were instructed to write down what they heard. They also rated each subject for the intelligibility of their speech production on a 5-point rating-scale. The main outcome measures were the percentage of target words correctly transcribed, and the intelligibility ratings, in both cases averaged across 3 normal-hearing listeners.

Results

The data showed a strong effect of age at testing, with older children being more intelligible. This effect was particularly pronounced for children implanted in the first 24 months of life, all of whom had speech production intelligibility scores of 80% or higher when they were tested at age 5.5 years or older. This was true for only 5 out of 9 children implanted at age 25-36 months.

Conclusions

Profoundly deaf children who receive cochlear implants in the first 2 years of life produce highly intelligible speech before the age of 6. This is also true for most, but not all children implanted in their third year.     

Auditory, speech and language development in young children with cochlear implants compared with children with normal hearing

Objective

This study had two aims: (1) to document the auditory and lexical development of children who are deaf and received the first cochlear implant (CI) by the age of 16 months and the second CI by the age of 31 months and (2) to compare these children's results with those of children with normal hearing (NH).

Methods

This longitudinal study included five children with NH and five with sensorineural deafness. All children of the second group were observed for 36 months after the first fitting of the device (cochlear implant). The auditory development of the CI group was documented every 3 months up to the age of two years in hearing age and chronological age and for the NH group in chronological age. The language development of each NH child was assessed at 12, 18, 24 and 36 months of chronological age. Children with CIs were examined at the same age intervals at chronological and hearing age.

Results

In both groups, children showed individual patterns of auditory and language development. The children with CIs developed differently in the amount of receptive and expressive vocabulary compared with the NH control group. Three children in the CI group needed almost 6 months to make gains in speech development that were consistent with what would be expected for their chronological age. Overall, the receptive and expressive development in all children of the implanted group increased with their hearing age.

Conclusion

These results indicate that early identification and early implantation is advisable to give children with sensorineural hearing loss a realistic chance to develop satisfactory expressive and receptive vocabulary and also to develop stable phonological, morphological and syntactical skills for school life. On the basis of these longitudinal data, we will be able to develop new diagnostic tools that enable clinicians to assess child's progress in hearing and speech development.     

A comparison of the speech recognition and pitch ranking abilities of children using a unilateral cochlear implant, bimodal stimulation or bilateral hearing aids

Objective

The present study compared the speech recognition and pitch ranking abilities of normally hearing children (n = 15) to children using a cochlear implant (CI) alone (n = 8), bilateral hearing aids (HAs) (n = 6), or bimodal stimulation (BMS) (n = 9). It was hypothesised that users of BMS would score higher on tasks of speech and pitch perception than children using a CI alone, but not children using HAs.

Methods

Participants were assessed on tasks of monosyllabic word recognition in quiet, sentence recognition in quiet and noise (10 dB signal-to-noise ratio), and a pitch ranking task using pairs of sung vowels one, half, and a quarter of an octave apart.

Results

There were no significant differences between the mean percentage-correct scores of the four participant groups for either words in quiet or sentences in quiet and noise. However, the proportion of bimodal users who scored >80% correct (80%) was significantly greater than the proportion of high-scoring unilateral CI (25%) or bilateral HA users (17%). Contrary to expectations, there was also no significant difference between the pitch ranking scores of users of BMS and users of a CI alone for all three interval sizes (p < 0.05, RM-ANOVA). However participants using only acoustic hearing (i.e. the NH and HA groups) scored significantly higher than participants using electrical stimulation (i.e. the CI and BMS groups) on the pitch ranking task (p < 0.05; RM-ANOVA).

Conclusions

Contrary to findings in postlingually deafened adults, we found no significant bimodal advantage for pitch perception in prelingually deafened children. However, the performance of children using electrical stimulation was significantly poorer than children using only acoustic stimulation. Further research is required to investigate the contribution of the non-implanted ears of users of BMS to pitch perception, and the effect of hearing loss on the development of pitch perception in children.     

Findings from multidisciplinary evaluation of children with permanent hearing loss

Objectives

To describe clinical findings from a multidisciplinary program for children with permanent hearing loss (PHL).

Methods

Retrospective chart review at a tertiary care children's hospital. Patients: Two hundred patients charts were selected from the population of 260 children with permanent hearing loss presenting between July 2005 and December 2006. Main outcome measures: PHL etiology; radiographic findings; clinical findings by genetics, ophthalmology, developmental pediatrics, speech pathology, and aural rehabilitation.

Results

Etiology of hearing loss was determined in 60% of subjects. Genetic causes of hearing loss were identified or presumed (positive history of first degree relative with hearing loss) in 27% of the children. Structural ear anomalies were found in 20% of children. Among the 36% of children with CNS imaging, abnormal findings were noted in 32%. There were a high rate of ophthalmological findings (53%) among children seen by ophthalmology (n = 105). Neurodevelopmental evaluations were completed in 58% of subjects and clinically significant findings were noted in 68%. Of the 61% of children who receiving received speech/language evaluations, 77% required intervention. Over half of the 40% of subjects who had an aural rehabilitation evaluation needed therapy. There were not significant differences in rates of findings for children with mild or unilateral hearing loss as compared to children with more severe degrees of hearing loss.

Conclusions

Interdisciplinary medical evaluation of children with PHL allows for the identification and treatment of clinically significant ophthalmologic, neurodevelopmental, genetic, and speech/language disorders. A high rate of CNS and temporal bone abnormalities were identified. These findings provide an understanding of the importance of considering thorough medical and developmental evaluations among children who are deaf/hard of hearing.     

Language development in children after receiving bilateral cochlear implants between 5 and 18 months

Objective

The objective of this study was to examine receptive and expressive language development in children who received simultaneous bilateral cochlear implants (CIs) between 5 and 18 months of age and to compare the results with language development in chronologically age-matched children with normal hearing.

Methods

The study used a prospective, longitudinal matched-group design. Data were collected in a clinical setting at postoperative cochlear implant check-ups after 3, 6, 9, 12, 18, 24, 36, and 48 months of implant use. The sample included 42 children: 21 cochlear implant users and 21 with normal hearing, matched pairwise according to gender and chronological age. Communication assessments included the LittlEARS questionnaire, the Mullen Scale of Early Learning, and the Minnesota Child Development Inventory.

Results

The cochlear implant users’ hearing function according to LittlEARS was comparable to that of normal-hearing children within 9 months post-implantation. The mean scores after 9 and 12 months were 31 and 33, respectively in the prelingually deaf versus 31 and 34 in the normal-hearing children. The children's receptive and expressive language scores showed that after 12-48 months with cochlear implants, 81% had receptive language skills within the normative range and 57% had expressive language skills within the normative range. The number of children who scored within the normal range increased with increasing CI experience.

Conclusions

The present study showed that prelingually deaf children's ability to develop complex expressive and receptive spoken language after early bilateral implantation appears promising.The majority of the children developed language skills at a faster pace than their hearing ages would suggest and over time achieved expressive and receptive language skills within the normative range.     

Speech development in children after cochlear implantation

We evaluated the long-term speech intelligibility of young deaf children after cochlear implantation (CI). A prospective study on 47 consecutively implanted deaf children with up to 5 years cochlear implant use was performed. The study was conducted at a pediatric tertiary referral center for CI. All children in the study were deaf prelingually. They each receive implant before the program of auditory verbal therapy. A speech intelligibility rating scale evaluated the spontaneous speech of each child before and at frequent interval for 5 years after implantation. After cochlear implantation, the difference between the speech intelligibility, rating increased significantly each year for 3 years (P < 0.05). For the first year, the average rating remained “prerecognizable words” or “unintelligible speech”. After 2 year of implantation the children had intelligible speech if someone concentrates and lip-reads (category 3). At the 4- and 5-year interval, 71.5 and 78% of children had intelligible speech to all listeners (category 5), respectively. So, 5 years after rehabilitation mode and median of speech intelligibility rating was five. Congenital and prelingually deaf children gradually develop intelligible speech that does not plateau 5 years after implantation.     

Effect of identification and intervention age on language development for Mandarin-speaking deaf children with high family involvement

Objective

The purpose of this study is to assess the language ability between early-intervention and later-intervention Mandarin-speaking deaf children, who have normal cognition and high family involvement.

Materials and methods

There are 29 subjects enrolled. 11 born deaf children received early intervention (7 HA and 4 CI) before 6 months old as study group. Another 18 born deaf children received later intervention (11 HA and 7 CI) between 7 and 35 months old as reference group. They were all regarded as with normal cognition and high family involvement. Their mean assessment age was 50 months old in early group and 51 months old in later group. We used several tools to test their perceptive vocabulary size, to evaluate perceptive language syntax and to compare perceptive and expressive language scores.

Results

Our study revealed there are significant difference between these two groups in the ability of vocabulary size, perceptive language syntax and perceptive language scores. The results showed there is no significant difference between these two groups in their expressive language scores, although their achievement score is higher in the early group.

Conclusions

It clearly showed the ability of perceptive language in early-intervention deaf children was better than that of later-intervention. The ability of their expressive language showed no difference between them.     

Spatial hearing of normally hearing and cochlear implanted children

Objective

Spatial hearing uses both monaural and binaural mechanisms that require sensitive hearing for normal function. Deaf children using either bilateral (BCI) or unilateral (UCI) cochlear implants would thus be expected to have poorer spatial hearing than normally hearing (NH) children. However, the relationship between spatial hearing in these various listener groups has not previously been extensively tested under ecologically valid conditions using a homogeneous group of children who are UCI users. We predicted that NH listeners would outperform BCI listeners who would, in turn, outperform UCI listeners.

Methods

We tested two methods of spatial hearing to provide norms for NH and UCI using children and preliminary data for BCI users. NH children (n = 40) were age matched (6-15 years) to UCI (n = 12) and BCI (n = 6) listeners. Testing used a horizontal ring of loudspeakers within a booth in a hospital outpatient clinic. In a ‘lateral release’ task, single nouns were presented frontally, and masking noises were presented frontally, or 90° left or right. In a ‘localization’ task, allowing head movements, nouns were presented from loudspeakers separated by 30°, 60° or 120° about the midline.

Results

Normally hearing children improved with age in speech detection in noise, but not in quiet or in lateral release. Implant users performed more poorly on all tasks. For frontal signals and noise, UCI and BCI listeners did not differ. For lateral noise, BCI listeners performed better on both sides (within ∼2 dB of NH), whereas UCI listeners benefited only when the noise was opposite the unimplanted ear. Both the BCI and, surprisingly, the UCI listeners performed better than chance at all loudspeaker separations on the ecologically valid, localization task. However, the BCI listeners performed about twice as well and, in two cases, approached the performance of NH children.

Conclusion

Children using either UCI or BCI have useful spatial hearing. BCI listeners gain benefits on both sides, and localize better, but not as well as NH listeners.     

Use of comb-filtered speech to demonstrate to parents how children adapt to hearing with an implant

Parents' knowledge of cochlear implantation (CI) is very limited. How could we graphically demonstrate the problems faced by implanted children to their parents?Parallels between speech perception of implanted patients and speech perception after comb filtration by normal hearing persons mean that it is possible to evaluate self-training of inexperienced subjects to perceive spectrally deprived speech and to show the complexities of implanted children's acoustic perception to the children's relatives. Speech consisted of five bands of the 50 Hz width in the frequency range of 200 to 6250 Hz. Eight mothers had to repeat words from two word lists. After seven to nine days of examination, all subjects achieved a plateau of intelligibility. The mean values of intelligibility in the first and the last tests were 32% and 84% respectively. There was no significant difference between the final result of self-training and the result of control list intelligibility (p > 0.05). The results obtained on the last day of the experiment confirm the successful development of perception of a new sound picture of speech. These results demonstrated to the mothers that high intelligibility achieved by them in the two repeated lists, was strengthened, by analogy with their children, as a new skill. The mothers of the children who received implants appreciated the demonstration and recommended that all mothers take part in assessments use this.     

Screening for delayed-onset hearing loss in preschool children who previously passed the newborn hearing screening

Objective

The goal of this study was to investigate the prevalence of delayed-onset hearing loss in preschool children who previously passed newborn hearing screening in Shanghai, China.

Methods

Between October 2009 and September 2010, 21,427 preschool children were enrolled from five areas of Shanghai, who had passed newborn hearing screening. Children were screened for delayed-onset hearing loss with pediatric audiometers. Children with positive results in initial and re-screening tests were assessed audiologically and for risk indicators according to the Year 2007 Statement of the American Joint Committee on Infant Hearing (JCIH).

Results

During the study period, 445 children (2.08%) were referred for audiologic assessment; 16 (0.75/1000, 95% CI 0.38-1.12) had permanent delayed-onset hearing loss. Of these, five (0.23/1000) had bilateral moderate hearing loss; seven (0.33/1000) had mild bilateral hearing loss; and four (0.19/1000) had unilateral moderate or mild hearing loss. JCIH risk indicators were established for six children (6/16, 37.5%), including parental concern regarding speech and language developmental delay, neonatal intensive care unit with assisted ventilation or hyperbilirubinemia, recurrent otitis media with effusion, craniofacial malformation, and family history (n = 1 for each). The remaining ten (62.5%) had no related risk factors.

Conclusions

A significant proportion of preschool children have undiagnosed delayed-onset hearing loss. Hearing screening in preschool is recommended for an early detection.     

Residual hearing and speech production in deaf children.

Residual hearing, phoneme recognition, speech production errors, and selected background variables were examined in 40 congenitally deaf children of normal intelligence who had no apparent anomalies other than deafness, in an effort to identify factors most closely associated with speech intelligibility. Mean intelligibility of the recorded speech of the children, to inexperienced listerners, was 18.7%, corresponding closely with results of previous studies. Scores on the total and some portions of the phoneme recognition test showed significant correlations with both phoneme production and speech intelligibility. The correlation between phoneme production errors and intelligibility was -0.80. A sizable proportion of the dispersion could be accounted for by certain prosodic errors, such as those resulting from improper phonatory control. Errors of place of articulation and voicing remained in essentially the same proportion for all speakers. Errors of manner and combined place and manner of articulation showed a slight systematic decrease from the poorest to the best speakers. Omissions decreased sharply, but not systematically. Vowel errors showed the most marked and systematic decrease as intelligibility improved. Children of deaf parents were poorer in phoneme recognition and in speech intelligibility than children with comparable residual hearing but with hearing parents.     

Reading skills in Persian deaf children with cochlear implants and hearing aids

ObjectivesReading skills are necessary for educational development in children. Many studies have shown that children with hearing loss often experience delays in reading. This study aimed to examine reading skills of Persian deaf children with cochlear implant and hearing aid and compare them with normal hearing counterparts.MethodThe sample consisted of 72 s and third grade Persian-speaking children aged 8–12 years. They were divided into three equal groups including 24 children with cochlear implant (CI), 24 children with hearing aid (HA), and 24 children with normal hearing (NH). Reading performance of participants was evaluated by the “Nama” reading test. “Nama” provides normative data for hearing and deaf children and consists of 10 subtests and the sum of the scores is regarded as reading performance score.ResultsResults of ANOVA on reading test showed that NH children had significantly better reading performance than deaf children with CI and HA in both grades (P < 0.001). Post-hoc analysis, using Tukey test, indicated that there was no significant difference between HA and CI groups in terms of non-word reading, word reading, and word comprehension skills (respectively, P = 0.976, P = 0.988, P = 0.998).ConclusionConsidering the findings, cochlear implantation is not significantly more effective than hearing aid for improvement of reading abilities. It is clear that even with considerable advances in hearing aid technology, many deaf children continue to find literacy a challenging struggle.     

Auditory performance and speech intelligibility of Mandarin-speaking children implanted before age 5

Objectives

(1) To report the auditory performance and speech intelligibility of 84 Mandarin-speaking prelingually deaf children after using cochlear implants (CIs) for one, two, three, four, and five years to understand how many years of implant use were needed for them to reach a plateau-level performance; (2) to investigate the relation between subjective rating scales and objective measurements (i.e., speech perception tests); (3) to understand the effect of age at implantation on auditory and speech development.

Methods

Eighty-four children with CIs participated in this study. Their auditory performance and speech intelligibility were rated using the Categorical Auditory Performance (CAP) and the Speech Intelligibility Rating (SIR) scales, respectively. The evaluations were made before implantation and six months, one, two, three, four, and five years after implantation. At the fifth year after implantation, monosyllabic-word, easy-sentence, and difficult-sentence perception tests were administered.

Results

The median CAP score reached a plateau at category 6 after three years of implant use. The median SIR arrived at the highest level after five years of use. With five years of CI experiences, 86% of the subjects understood conversation without lip-reading, and 58% were fully intelligible to all listeners. The three speech perception tests had a moderate-to-strong correlation with the CAP and SIR scores. The children implanted before the age of three years had significantly better CAP and monosyllabic word perception test scores.

Conclusions

Five years of follow-up are needed for assessing the post-implantation development of communication ability of prelingually deafened children. It is recommended that hearing-impaired children receive cochlear implantation at a younger age to acquire better auditory ability for developing language skills. Constant postoperative aural–verbal rehabilitation and speech and language therapy are most likely required for the patients to reach the highest level on the CAP and SIR scales.     

Speech and language acquisition in young children after cochlear implantation.

Auditory and speech intelligibility scores of 22 prelingually profoundly deaf children who had used cochlear implants for between 1 and 7 years in an intensive auditory/oral educational program greatly exceeded those previously obtained from similar samples of deaf children using hearing aids. Half of the children obtained language quotient scores within the average range for normal-hearing children and the majority obtained reading quotients within 80% of normal levels. Normal levels of language and reading development were associated with early implantation and open set speech perception.     

Problemy zdrowia psychicznego matek i ojców dzieci głuchych z implantem ślimakowym

Introduction

Child's deafness is a risk factor for the mental health of its parents. This study addresses a question whether mothers and fathers of the prelingually deaf children using cochlear implants (CI) experience a different intensity of psychopathology symptoms than parents of the hearing, typically developing children, and also if the intensity of those symptoms experienced by parents is related to how long their child is a cochlear implant user.

Material and methods

In this study participated 153 hearing parents of the deaf children using a single cochlear implant (111 mothers, 42 fathers), and parents of the hearing children. Mean age of deaf children was 72 months, cochlear implant use duration was between 1 and 124 months. The control group of parents has been selected taking into account their typically developing child's sex and age. The parents’ mental health has been assessed with Goldberg General Health Questionnaire GHQ-28 in Polish adaptation.

Results

Mothers of deaf, CI using children experience significantly more symptoms of anxiety and insomnia compared to the mothers of typically developing children, while fathers of these children show the tendency for the increased level of depression symptoms compared to the fathers from the control group. In the group of deaf CI children mothers relate substantially more somatic and anxiety symptoms than fathers, whereas level of experiencing depression symptoms and problems in everyday functioning is similar in mothers and fathers. No relation between the duration of child's CI use and parents’ mental health has been ascertained.

Conclusions

The mental health of parents of the deaf CI using children indicates that both mothers and fathers have problems in this sphere related to their child's deafness, but not to the duration of child's CI use. Parents of deaf, CI using children may need psychological help regardless of the time their child has been using the cochlear implant.     

Behavioral and electrophysiological investigation of hearing and speech outcomes in pre-linguistic deaf children with white matter changes after cochlear implantation

Abstract

Background: There are some debates regarding the benefit from cochlear implantation (CI) for prelingually deaf children with white matter changes.

Objective: To assess the hearing and speech outcomes of prelingually deaf children with white matter changes (group A), and those with complete deafness (group B), at 2?years after CI.

Material and Methods: Study 1 included 32 and 34 children in group A and B, respectively. The Categories of Auditory Performance (CAP) and Speech Intelligibility Rate (SIR) were used to assess the performance on hearing and speech. Study 2 included eight children with white matter changes and eight with complete deafness at 2?years post-CI, and nine normal-hearing peers. The mismatch response (MMR) to the stimulus pair ‘ba’/‘pa’ was investigated.

Results: There was no significant difference on CAP or SIR scores between the children in group A and B. All children with white matter changes showed MMRs to Mandarin consonants at 2?years post-CI. And there was no significant difference on the incidence, the latency or amplitude of MMR among three groups.

Conclusions and significance: Most prelingually deaf children with white matter changes got good outcomes from CI. CI is not a contraindication for most individuals with white matter changes.