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.     

Children with hearing impairment--living with cochlear implants or hearing aids

Objective

The aim of this study was to enhance knowledge about the life circumstances of children with cochlear implants or hearing aids, regarding daily functioning and attitude to the impairment.

Methods

Data were obtained from 36 children with cochlear implants and 38 children with hearing aids via study-specific questionnaires with fixed answer alternatives. The questions covered (1) usage of aids and related factors, (2) hearing in different everyday situations, (3) thoughts about the children's own hearing and others’ attitudes to it, and (4) choice of language. The data were analyzed using SPSS, and presented via the theoretical frame of the International Classification of Functioning, Disability and Health, Child and Youth version (ICF-CY).

Results

Children with CI and HA functioned equally well in daily life, but there were also certain differences. Symptoms from neck and shoulders were more common among children with hearing aids than among children with cochlear implants (p < .001). Children with hearing aids used their aids significantly less often than those with cochlear implants (p < .001). The participation variables showed that children with hearing aids had significantly more hearing problems in team sports (p = .033) and outdoor activities (p = .019), in comparison to children with cochlear implants. The two groups had similar thoughts regarding their own hearing, mostly considering it not to be a problem. They also did not generally think that other people found their hearing to be a problem.

Conclusions

Children with cochlear implants and children with hearing aids have, in some aspects, equally good functioning in everyday life situations. However, certain differences were found in dimensions of functioning, regarding neck and shoulder pain, usage of aids and sign language, and hearing problems in some activities.     

Performance in children with hearing aids or cochlear implants: bilateral stimulation and binaural hearing

It is well recognised that normal hearing people use their hearing in both ears to locate sounds and to understand speech in complex listening conditions. Whereas it is standard practice to provide two hearing aids to children with bilateral hearing loss, the situation with cochlear implantation is less certain. Questions remain as to what binaural aided functioning is possible for children who use a hearing aid and a cochlear implant in opposite ears (bimodal hearing). The first part of this paper draws on research at the National Acoustic Laboratories to show that children who used bimodal hearing devices obtained binaural advantages in localization. They could also take advantage of head shadow and binaural redundancy for speech intelligibility. The second part presents data showing that some hearing-impaired children may have binaural processing deficits even when bilateral stimulation is provided. Additional strategies may be necessary to develop or enable the use of binaural cues by these children.     

Mandarin lexical tones identification among children with cochlear implants or hearing aids

ObjectivesMandarin Chinese is a lexical tone language that has four tones, with a change in tone denoting a change in lexical meaning. There are few studies regarding lexical tone identification abilities in deafened children using either cochlear implants (CIs) or hearing aids (HAs). Furthermore, no study has compared the lexical tone identification abilities of deafened children with their hearing devices turned on and off. The present study aimed to investigate the lexical tone identification abilities of deafened children with CIs or HAs.MethodsForty prelingually deafened children (20 with CIs and 20 with HAs) participated in the study. In the HA group, 20 children were binaurally aided. In the CI group, all of the children were unilaterally implanted. All of the subjects completed a computerized lexical tone pairs test with their hearing devices turned on and off. The correct answers of all items were recorded as the total score and the correct answers of the tone pairs were recorded as subtotal scores.ResultsNo significant differences in the tone pair identification scores were found between the CI group and HA group either with the devices turned on or off (t = 1.62, p = 0.11; t = 1.863, p = 0.07, respectively). The scores in the aided condition were higher than in the unaided condition regardless of the device used (t = 22.09, p < 0.001, in the HA group; t = 20.20, p < 0.001, in the CI group). Significantly higher scores were found in the tone pairs that contained tone 4. Age at fitting of the devices was correlated with tone identification abilities in both the CI and HA groups. Other demographic factors were not correlated with tone identification ability.ConclusionsThe hearing device, whether a hearing aid or cochlear implant, is beneficial for tone identification. The lexical tone identification abilities were similar regardless of whether the subjects wore a HA or CI. Lexical tone pairs with different durations and dissimilar tone contour patterns are more easily identified. Receiving devices at earlier age tends to produce better lexical tone identification abilities in prelingually deafened children.     

Benefits of bilateral cochlear implants and/or hearing aids in children

This study evaluated functional benefits from bilateral stimulation in 20 children ages 4-14, 10 use two CIs and 10 use one CI and one HA. Localization acuity was measured with the minimum audible angle (MAA). Speech intelligibility was measured in quiet, and in the presence of 2-talker competing speech using the CRISP forced-choice test. Results show that both groups perform similarly when speech reception thresholds are evaluated. However, there appears to be benefit (improved MAA and speech thresholds) from wearing two devices compared with a single device that is significantly greater in the group with two CI than in the bimodal group. Individual variability also suggests that some children perform similarly to normal-hearing children, while others clearly do not. Future advances in binaural fitting strategies and improved speech processing schemes that maximize binaural sensitivity will no doubt contribute to increasing the binaurally-driven advantages in persons with bilateral CIs.     

The educational settings of profoundly deaf children with cochlear implants compared with age-matched peers with hearing aids: implications for management

The educational settings of 42 implanted profoundly deaf children 3 years after implantation were compared with the respective settings of 635 age-matched severely deaf and 511 profoundly deaf children with hearing aids. All implanted children received their implants before beginning school. The results revealed that 3 years after implantation. 38% (16 children) of the implanted profoundly deaf children attended mainstream schools, whereas 57% (24 children) were in a unit, or special class, in a mainstream school, and 5% (two children) were in schools for the deaf. With regard to the age-matched profoundly deaf children with hearing aids, 12% (63 children) attended mainstream schools, whereas 55% (281 children) were in a unit of a mainstream school, and 33% (167 children) were in schools for the deaf. In the group of age-matched severely deaf children, 38% (239 children) attended mainstream schools, whereas 51% (326 children) were in a unit of a mainstream school, and 11% (70 children) were in schools for the deaf. Statistical analysis revealed a highly significant difference between the educational placement of implanted children and hearing-aided profoundly deaf children (p<0.00001), whereas there was no statistically significant difference between implanted children and hearing-aided severely deaf children. In conclusion, implanted profoundly deaf children who have received their implants before beginning school have the same profile of educational placement as aided severely deaf children rather than aided profoundly deaf children of the same age in the UK. This is likely to have significant implications for the future management of profoundly deaf children and to influence future planning of educational support services.     

Comparison of outcomes in children with hearing aids and cochlear implants

Abstract

Objectives

The purpose of this study was to document the performance of a group of children with moderately severe to severe hearing loss who use hearing aids on a range of speech recognition, speech–language, and literacy measures and to compare these results to children with severe to profound hearing loss, who have learned language through cochlear implants.

Methods

This study involved 41 children with bilateral sensorineural hearing impairment, aged 6–18 years. Twenty children had moderately severe/severe hearing loss and used hearing aids, and 21 had severe to profound hearing loss and used cochlear implants. Communication and academic skills were assessed using speech recognition tests and standardized measures of speech production, language, phonology, and literacy.

Results

The two groups did not differ in their open-set speech recognition abilities or speech production skills. However, children with hearing aids obtained higher scores than their peers with cochlear implants in the domains of receptive vocabulary, language, phonological memory, and reading comprehension. The findings also indicate that children with moderately severe or severe hearing loss can develop spoken language skills that are within the range expected for normal hearing children.

Conclusions

School-aged children with moderately severe and severe hearing loss performed better in several domains than their peers with profound hearing loss who received cochlear implants between age 2 and 5 years. Further research is required to evaluate the benefits of hearing aids and cochlear implants in children with hearing loss who are diagnosed and receive intervention within the first year of life.     

Comparison of hearing aids and cochlear implants in profoundly and totally deaf persons

Cochlear implants are increasingly used in the rehabilitation of the profoundly and totally deaf. Usually, insufficient gain of speech discrimination with a powerful conventional hearing aid is considered as a prerequisite for a cochlear prosthesis. With recent improvements of electronic systems, the criterion for this decision may change. To keep pace with the technical progress, a battery of speech sound tests suited for minimal auditory capabilities (MAC-battery) was developed and applied to groups of patients fitted with conventional instruments and with two different types of cochlear implants. Based on the comparison of the MAC-battery results of hearing aid groups, with the average performance of an implanted group, most conventionally fitted regular users of hearing aids should not be considered as candidates for cochlear implantation. The MAC-battery, although not a strictly standardized procedure, is a useful instrument for patient counselling and for the selection of implant candidates.     

语前聋患儿一侧人工耳蜗对侧助听器效果分析

目的:通过对人工耳蜗植入对侧耳不同听力损失的患儿联合使用助听器与人工耳蜗语前聋患儿的听觉、语言及学习能力进行评估和比较,探索对患儿更为有效的助听方法,帮助患儿获得最大限度的言语交流。方法:将30例3～6岁语前聋患儿按照植入人工耳蜗对侧耳听力损失程度及是否佩戴助听器,分为一侧人工耳蜗+对侧重度听力损失助听器组(CI+SHA组)、一侧人工耳蜗+对侧极重度听力损失助听器组(CI+PHA组)、单耳人工耳蜗组(CI组)。评估各组在康复3、6、9、12、15、18个月时听觉、语言及学习能力,并记录结果。结果:随着术后康复时间的延长,聋儿听觉、语言及学习能力逐渐提高(P<0.05),CI+SHA组听觉能力优于CI+PHA组及CI组(均P<0.05),语言能力及学习能力无明显差异(P>0.05)。结论:语前聋患儿单耳人工耳蜗植入后,若对侧耳尚有残余听力,佩戴助听器后听觉能力效果显著,长期佩戴有助于患儿的康复。     

Visual attention in children with normal hearing, children with hearing aids, and children with cochlear implants.

Previous studies have reported both positive and negative effects of deafness on visual attention. The purpose of this study was to replicate and expand findings of previous studies by examining visual attention abilities in children with deafness and children with normal hearing. Twenty-eight children, ages 8-14 years, were evaluated. There were two groups of children with prelingual deafness and one group with normal hearing. The children with deafness were divided further into two groups: those with cochlear implants and those with conventional hearing aids. Unlike previous studies, the current study found no substantial differences in performance among these three groups of children on a continuous-performance visual attention task or on a letter cancellation task. Children in all three groups performed very well on the visual attention tasks. Furthermore, there was little association between performance on the visual attention tasks and parent or teacher ratings of behavior and attention. Age and nonverbal intelligence were significantly correlated with performance on visual attention tasks. The theoretical implications of these findings are discussed, along with directions for future research.     

Selection of hearing aids for severely deaf children

Procedures are described for selecting the gain and frequency response of hearing aids for deaf children and for evaluating aided hearing. These include a comparison of aided thresholds with the speech spectrum to determine how much of the frequency range is functional for each child. This provides a basis for deciding whether to select an aid having a "conventional" (C) response, which de-emphasises the low frequencies, or a low frequency (LF) response which provides more low frequency gain, although not necessarily low frequency emphasis. It is concluded that, for optical aid fitting, some children require "C" responses for both ears, others "LF" responses for both ears and others a "C" response for one ear and an "LF" response for the other. These three possibilities are all required sufficiently commonly that exclusive use of any one would inevitably result in relatively ineffective amplification for many deaf children.     

The cognition and behaviour of children with cochlear implants, children with hearing aids and their hearing peers: a comparison

Hearing impairment has been associated with cognitive deficits. It is not yet clear whether cochlear implants enable children to reduce or overcome these deficits. This study examined whether hearing impaired children with cochlear implants differed from hearing impaired children without cochlear implants or from hearing children. The three age-matched groups were compared on a non-verbal measure of cognition, the Leiter International Performance Scale-Revised (LIPS-R), and a measure of behaviour, the Child Behaviour Checklist (CBCL). Apart from their scores on the Attention Sustained Subtest of the LIPS-R, the performance of the implanted group and the hearing group closely corresponded, while the hearing impaired children without cochlear implants performed below the level achieved by both these groups. There were no differences between any groups on the CBCL. It was concluded that hearing impaired children with cochlear implants were able to perform at the same non-verbal cognitive level as hearing children.