A Structural Equation Modeling Approach to Examining Factors Influencing Outcomes with Cochlear Implant in Mandarin-Speaking Children.

Yuan Chen,Xin Xi,Lena L N Wong,Shufeng Zhu,Bernd Sokolowski

doi:10.1371/journal.pone.0136576

Abstract

ObjectiveTo examine the direct and indirect effects of demographical factors on speech perception and vocabulary outcomes of Mandarin-speaking children with cochlear implants (CIs).Methods115 participants implanted before the age of 5 and who had used CI before 1 to 3 years were evaluated using a battery of speech perception and vocabulary tests. Structural equation modeling was used to test the hypotheses proposed.ResultsEarly implantation significantly contributed to speech perception outcomes while having undergone a hearing aid trial (HAT) before implantation, maternal educational level (MEL), and having undergone universal newborn hearing screening (UNHS) before implantation had indirect effects on speech perception outcomes via their effects on age at implantation. In addition, both age at implantation and MEL had direct and indirect effects on vocabulary skills, while UNHS and HAT had indirect effects on vocabulary outcomes via their effects on age at implantation.ConclusionA number of factors had indirect and direct effects on speech perception and vocabulary outcomes in Mandarin-speaking children with CIs and these factors were not necessarily identical to those reported among their English-speaking counterparts.

Highlights

A number of factors have been found to account for the diversity of speech perception and vocabulary skills after cochlear implantation
A number of factors had indirect and direct effects on speech perception and vocabulary outcomes in Mandarin-speaking children with cochlear implants (CIs) and these factors were not necessarily identical to those reported among their English-speaking counterparts
Previous studies have shown that late age at implantation, failure to undergo a hearing aid trial (HAT) before implantation, and low maternal education level (MEL) are significantly related to poor speech perception in Mandarin-speaking children with CIs [11]

Summary

Introduction

A number of factors have been found to account for the diversity of speech perception and vocabulary skills after cochlear implantation These variables include age at implantation [1, 2], preoperative residual hearing [3], duration of Cochlear implant (CI) use [4], device characteristics such as speech coding strategies and dynamic range [5], cognitive ability [6], mode of communication [7], and parental education [6]. The identification of these predictive factors are of importance for determination of CI candidacy and habilitation. Previous studies have shown that late age at implantation, failure to undergo a HAT before implantation, and low maternal education level (MEL) are significantly related to poor speech perception in Mandarin-speaking children with CIs [11]

Methods

Results

Conclusion