Hearing-impaired Children Research Articles

Evaluation of Hearing Status in Various Type of Cerebral Palsy Children in a Tertiary Hospital

Background: Cerebral palsy (CP) in children are frequently associated with sensorineural pathology.
 Objectives: To assess the severity of hearing impairment in children with CP and correlate the auditory impairment with different types of CP.
 Materials & Methods: This cross-sectional study was conducted in the Department of Pediatric neurology and Autolaryngiology- Head and Neck Surgery BSMMU, during March to September 2011. Diagnosed CP patients were included consecutively. After taking informed written consent, proper history and clinical examinations was done and severity of hearing loss was assessed.
 Results: Among the 50 children with CP, Tympanometry result revealed that negative middle ear pressure was present in 32% in spastic quadriplegia(SQ), 24% in spastic hemiplegia (SH), 16% in spastic diplegia (SD) and 24% in mixed type. Eustachian tube dysfunction was present in 62.5% in spastic hemiplegia. In TOAE result 52% were pass and 48% were referred and ABR were suggested. On the basis of result of TOAE, those were referred, initially they were encountered as hearing impairment in this study. Among them, in SQ were 18%, SH were 12% and mixed. Follow up auditory brain stem response revealed mild, moderate and severe sensorineural hearing loss were 8% in spastic quadriplegic type and the spastic diplegia and athetoid group were 2% only mild, Moderate sensorineural hearing were 2% in spastic hemiplegia group.
 Conclusion: Spastic Quadriplegic cerebral palsy patients had the maximum incidence of hearing impairment. Perinatal asphyxia and prematurity were the main risk factor of hearing impairment.
 BANGLADESH J CHILD HEALTH 2022; VOL 46 (1) : 19-22

Hearing impairment after asphyxia and neonatal encephalopathy: a Norwegian population-based study.

The purpose of this study is to evaluate the association between perinatal asphyxia, neonatal encephalopathy, and childhood hearing impairment. This is a population-basedstudy including all Norwegian infants born ≥ 36weeks gestation between 1999 and 2014 and alive at 2years (n = 866,232). Data was linked from five national health registries with follow-up through 2019. Perinatal asphyxia was defined as need for neonatal intensive care unit (NICU) admission and an Apgar 5-min score of 4-6 (moderate) or 0-3 (severe). We coined infants with seizures and an Apgar 5-min score < 7 as neonatal encephalopathy with seizures. Infants who received therapeutic hypothermia were considered to have moderate-severe hypoxic-ischemic encephalopathy (HIE). The reference group for comparisons were non-admitted infants with Apgar 5-min score ≥ 7. We used logistic regression models and present data as adjusted odds ratios (aORs) with 95% confidence intervals (CI). The aOR for hearing impairment was increased in all infants admitted to NICU: moderate asphyxia aOR 2.2 (95% CI 1.7-2.9), severe asphyxia aOR 5.2 (95% CI 3.6-7.5), neonatal encephalopathy with seizures aOR 7.0 (95% CI 2.6-19.0), and moderate-severe HIE aOR 10.7 (95% CI 5.3-22.0). However, non-admitted infants with Apgar 5-min scores < 7 did not have increased OR of hearing impairment. The aOR for hearing impairment for individual Apgar 5-min scores in NICU infants increased with decreasing Apgar scores and was 13.6 (95% CI 5.9-31.3) when the score was 0. Conclusions: An Apgar 5-min score < 7 in combination with NICU admission is an independent risk factor for hearing impairment. Children with moderate-severe HIE had the highest risk for hearing impairment. What is Known: • Perinatal asphyxia and neonatal encephalopathy are associated with an increased risk of hearing impairment. • The strength of the association, and how other co-morbidities affect the risk of hearing impairment, is poorly defined. What is New: • Among neonates admitted to a neonatal intensive care unit (NICU), decreased Apgar 5-min scores, and increased severity of neonatal encephalopathy, were associated with a gradual rise in risk of hearing impairment. • Neonates with an Apgar 5-min score 7, but without NICU admission, did not have an increased risk of hearing impairment.

Auditory Cortex Maturation and Language Development in Children with Hearing Loss and Additional Disabilities.

A significant portion of hearing-impaired children have additional disabilities, but data about the maturation of their auditory cortex are scarce. In these children, behavioral tests are often unreliable, and objective tests are needed for diagnostics and follow-up. This study aimed to explore auditory cortical maturation and language development, and the usability of an objective electroencephalogram-based biomarker in children with multiple disabilities. In 65 hearing aid and cochlear implant users (36 females; 36 with multiple disabilities; 44.3 ± 18.5 months of age, mean ± SD), auditory processing was examined using the P1 cortical auditory evoked response biomarker, and language development with the Preschool Language Scales 5th edition (PLS-5). During the study, all of the children received intensive extra language therapy for six months. No significant differences were found between the groups in P1 latency development, the proportion of abnormal P1 latencies, or the number of children whose P1 latencies changed from abnormal to normal during the study. The PLS-5 total language scores, auditory comprehension scores, or expressive communication scores did not differ between groups either. The P1 latencies showed meaningful negative correlations with the language scores. The results suggest that auditory cortex development is similar in hearing-impaired children with/without additional disabilities, and the P1 biomarker is a feasible tool to evaluate central auditory maturation in children with multiple disabilities.

Emotional Storyteller for Vision Impaired and Hearing-Impaired Children

Tellie is an innovative mobile app designed to offer an immersive and emotionally enriched storytelling experience for children who are visually and hearing impaired. It achieves this through four main objectives: Text extraction utilizes the CRAFT model and a combination of Convolutional Neural Networks (CNNs), Connectionist Temporal Classification (CTC), and Long Short-Term Memory (LSTM) networks to accurately extract and recognize text from images in storybooks. Recognition of Emotions in Sentences employs BERT to detect and distinguish emotions at the sentence level including happiness, anger, sadness, and surprise. Conversion of Text to Human Natural Audio with Emotion transforms text into emotionally expressive audio using Tacotron2 and Wave Glow, enhancing the synthesized speech with emotional styles to create engaging audio narratives. Conversion of Text to Sign Language: To cater to the Deaf and hard-of-hearing community, Tellie translates text into sign language using CNNs, ensuring alignment with real sign language expressions. These objectives combine to create Tellie, a groundbreaking app that empowers visually and hearing-impaired children with access to captivating storytelling experiences, promoting accessibility and inclusivity through the harmonious integration of language, creativity, and technology. This research demonstrates the potential of advanced technologies in fostering inclusive and emotionally engaging storytelling for all children.

Parental knowledge and attitudes towards hereditary hearing loss and genetic technology

&lt;b&gt;Introduction:&lt;/b&gt; The knowledge and attitudes about genetic hearing loss are essential to prevent more hearing loss incidences in societies. However, limited studies have compared the knowledge and attitude toward genetic technology between parents of normal and impaired-hearing children.&lt;br /&gt; &amp;nbsp;&lt;b&gt;Methods:&lt;/b&gt; A descriptive, cross-sectional study was performed involving&lt;b&gt; &lt;/b&gt;105 parents with one or more children having a hearing impairment and 204 control parents with children having normal hearing. Parents completed surveys designed to investigate their knowledge and attitudes about the genetic basis of hearing impairment and recent technologies. Descriptive and inferential statistics were used to measure response differences between the two groups.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; Both groups shared the same level of knowledge, with the average knowledge scores of parents with normal-hearing children (9.53/19±2.56 points) resembling those of parents with hearing-impaired children (10.08/19±3.17 points; F(1, 307)=-2.17, p=0.14). Moreover, parents had limited information about the genetic basis of hearing loss, specifically in estimating the recurrence of congenital hearing loss (n=26 of 105, 24.76%)and misunderstanding inheritance paradigms (n=24 of 105, 22.86%). Regardless of having children with auditory issues, parents expressed positive attitudes towards genetic testing.&lt;br /&gt; &lt;b&gt;Conclusions:&lt;/b&gt; These findings suggest that more genetic specialists are needed to educate families of children with hearing loss about the genetic attributes of hearing impairment and the significance of genetic technology.

Paediatric amplification protocol, based on individualization of the hearing aids’ fitting parameters

Background. There are no paediatric amplification clinical practice guidelines in Russia at the moment. At the same time the technological progress of hearing aids (HA), new algorithms and functions requires the objective evidence of safety and effectiveness for the hearing impaired children. For these reasons paediatric amplification algorithm was developed by the authors. Besides the standard procedures the algorithm includes an objective electroacoustic verification of the output parameters and separate HA functions. The research is devoted to the investigation of the protocols advantages. &#x0D; Aim development and evaluation the paediatric amplification protocol, based on objective electroacoustic verification of the output and functions of hearing aid. &#x0D; Materials and Methods. Prospective, randomized, controlled clinical trial was performed. Two protocols effectiveness were compared. Standard protocol (control group) is based on the subjective verification. Experimental protocol suggests an electroacoustic verification of the output and different HA functions: feedback cancellation, amplitude and frequency compression, microphone directionality, digital noise reduction (experimental group). Each group included 56 children (317 years old) with permanent hearing loss from moderate to moderately-severe degree. Initial amplification was performed for each child; the results were estimated in 1, 3 and 6 months using PEACH and LIFE questionnaires, speech audiometry and phoneme testing. DataLogging and first fitting appointment time were also estimated. &#x0D; Results. In preschool-age children of the experimental group post-amplification PEACH results were 6% better than in controls. In school-age children (LIFE questionnaire) results were 11% better comparing with control group. Speech intelligibility in quiet was 3.1% (p 0.05) higher for pre-schoolers in the experimental group and 9.3% (p 0.01) higher for school-age children comparing with control group. Speech intelligibility in noise was higher in experimental group than in control: 7.8% (p 0.05) in pre-schoolers and 13% (p 0.01) for school-age children. Phoneme recognition was better in experimental group as well: 4.5% (p 0.05) in pre-schoolers and 9.8% (p 0.01) in school-agers than in control group. After HA fitting following an experimental protocol DataLogging time was 1112% longer in comparison with standard procedure. On the other hand, experimental protocol took in average 1.5 hours for the first fitting and standard protocol 53 minutes. &#x0D; Conclusions. Protocol of paediatric amplification based on objective electroacoustic verification of HA output and functions allows to significantly increase the effectiveness of hearing rehabilitation in children.

An insight into attitude about usage of ICT by teachers in school for hearing impaired

Background: Information and Communication Technology (ICT) in education is the mode of education that depends on digital medium of information transfer for delivery of course content and related learning experiences. Its focus is on utilization of different technologies in order to support, enhance, and optimise the delivery of information. ICT can be used in many ways to help both the students and the teachers gain knowledge on a particular topic/subject. The present study was inclined to look into the attitude of teacher for the hearing impaired towards usage of ICT in classrooms. Methods: Questionnaire which consists of attitude of teachers towards ICT. The questionnaire used for this study was adopted and modified from the original questionnaire designed by Gulbahar and Guven (2008), Ghavifekr and Athirah (2015) that is considered suitable for this research. Descriptive statistics was carried out for analyzing the data in SPSS version 20.0. Results: For all the questions framed to elicit positive opinions, the median values were either 4 i.e. agree is the common response of all the judges. For questions framed to elicit the common response is either disagree or strongly disagree. The responses of the judges suggest that they consider ICT to be helpful for teaching-learning of hearing impaired children. Conclusions: The study was able to demonstrate that ICT tools have gained popularity among the teachers of hearing impaired included in the study.

Особенности временной перспективы у слабослышащих детей старшего подросткового возраста

The research interest of modern scientists is focused on the issues of interpersonal interaction of hearing-impaired children, peculiarities of their self-perception and the surrounding reality, developing higher mental functions in ontogenesis against the background of sensory deficiency. However, it is revealed that the number of scientific works disclosing the peculiarities of temporal orientations of adolescents with hearing impairment is insignificant, while the need for them is obvious. The aim of this study is to investigate the specific features of temporal perspective in hearing-impaired adolescents and to identify correlations between its indicators and executive functions in order to further develop a correctional and developmental program aimed at optimizing the latter and changing the temporal perspective towards balance. According to the study, conventionally healthy adolescents are more focused on enjoying events in the present, while their hearing-impaired peers reflect on the implications of their behavior in the future, but differ in a less sentimental attitude to past experi-ences and do not regard it as meaningful for the present.

Особенности координационных функций у слабослышащих детей младшего школьного возраста: концептуальная модель исследования

&lt;p style="text-align: justify;"&gt;The article is devoted to the development of a conceptual model for studying the features of coordination functions (static, dynamic, spatial, object and symbolic coordination) in hearing-impaired children of primary school age based on the results of a pilot study. As you know, the relationship between auditory perception and coordination functions is determined not only by the visual analyzer, but also by the auditory one. The signals coming from the auditory and visual analyzer are the regulators of human movements. Therefore, the loss of the auditory canal from this system leads to a violation of the development of coordination functions, and subsequently affects the mental development of the child, his relationship with other people and adaptation in society. As a key approach to understanding the features of coordination functions, the level psychophysiological theory of N.A. Bernstein (provisions on the theory of the coordination function), according to which each new systemic level of movement construction develops on the basis of the previous one and includes it, and the previous level acquires a new quality and is enriched at the expense of the next one. In our study, the movement building system is five-level and includes the level of static coordination (A), the level of dynamic coordination (B), the level of spatial coordination (C) and the level of object coordination (D) and the level of symbolic coordination (E). In accordance with the results obtained, there is an immaturity of coordination functions and a decrease in their dynamic characteristics such as tempo and accuracy, which indicates the insufficiency of all these levels of movement organization in children of primary school age with sensorineural hearing loss in comparison with children without hearing impairment.&lt;/p&gt;

Neural envelope tracking predicts speech intelligibility and hearing aid benefit in children with hearing loss

Early assessment of hearing aid benefit is crucial, as the extent to which hearing aids provide audible speech information predicts speech and language outcomes. A growing body of research has proposed neural envelope tracking as an objective measure of speech intelligibility, particularly for individuals unable to provide reliable behavioral feedback. However, its potential for evaluating speech intelligibility and hearing aid benefit in children with hearing loss remains unexplored. In this study, we investigated neural envelope tracking in children with permanent hearing loss through two separate experiments. EEG data were recorded while children listened to age-appropriate stories (Experiment 1) or an animated movie (Experiment 2) under aided and unaided conditions (using personal hearing aids) at multiple stimulus intensities. Neural envelope tracking was evaluated using a linear decoder reconstructing the speech envelope from the EEG in the delta band (0.5-4 Hz). Additionally, we calculated temporal response functions (TRFs) to investigate the spatio-temporal dynamics of the response. In both experiments, neural tracking increased with increasing stimulus intensity, but only in the unaided condition. In the aided condition, neural tracking remained stable across a wide range of intensities, as long as speech intelligibility was maintained. Similarly, TRF amplitudes increased with increasing stimulus intensity in the unaided condition, while in the aided condition significant differences were found in TRF latency rather than TRF amplitude. This suggests that decreasing stimulus intensity does not necessarily impact neural tracking. Furthermore, the use of personal hearing aids significantly enhanced neural envelope tracking, particularly in challenging speech conditions that would be inaudible when unaided. Finally, we found a strong correlation between neural envelope tracking and behaviorally measured speech intelligibility for both narrated stories (Experiment 1) and movie stimuli (Experiment 2). Altogether, these findings indicate that neural envelope tracking could be a valuable tool for predicting speech intelligibility benefits derived from personal hearing aids in hearing-impaired children. Incorporating narrated stories or engaging movies expands the accessibility of these methods even in clinical settings, offering new avenues for using objective speech measures to guide pediatric audiology decision-making.

The Improvement of Articulation Ability on Bilabial Letters Using Abata Method in the Hearing Impaired Students

This research aims to find out the effect of Abata method implementation in improving the articulation ability on bilabial letters in the hearing impaired child of Abata Boarding School. In the beginning of assessment, it was found that the child performed the phoneme substitution on all bilabial letters (p-b-m-w), in which all bilabial letters were pronounced like the letter 'w' that was imperfect. This research used SSR (Single Subject Research) method and A-B-A (Applied Behaviour Analysis) design. The subject in this research was a hearing impaired child in class II of Abata Boarding School in Temanggung. The data collection technique was implemented using a test of articulation ability on bilabial letters and observation. The data analysis used in this research was descriptive statistics, through direct observation on graphic and table. Based on the data processing, the mean level percentages were 25% in the baseline-1 phase, 60% in the intervention phase, and 72.5% in the baseline-2 phase. Calculation of the overlapping percentage from baseline-1 phase to intervention phase was 0%. The research shows the result that the Abata method is capable of improving the articulation capability on bilabial letters in the hearing impaired child of Abata Boarding School.

Comparison of Powered Toothbrushes and Manual Toothbrushes in Removing Dental Plaque among Children with hearing Disabilities: A Randomized Pilot Study

OBJECTIVE: This study aimed to compare the the effectiveness of plaque removal between manual and powered toothbrushes in hearing impaired children. Maintaining a good quality of life requires optimal levels of oral hygiene. In differently abled subjects, manual dexterity may be slightly compromised, which is why powered toothbrushes were initially designed to help overcome the slight deficit. METHODOLOGY: A parallel arm, randomized study was conducted. Twenty two congenitally hearing-impaired participants aged eighteen to twenty two of age were recruited from National Special Education Centre for Hearing Impaired Children,Islamabad. They were randomly divided into two groups of eleven participants. Plaque levels were evaluated on the first day and plaque removal effectiveness of powered toothbrushes compared with manual toothbrush was checked on the eighth day. Plaque scores were evaluated using the simplified Oral Hygiene Index and Turesky's Modification of Quigley Hein Plaque Index. RESULTS: No significant difference of Mean score in effectiveness of plaque removal between manual and powered toothbrushes was seen. CONCLUSIONS: Manual and powered toothbrushes are equally effective at plaque . More studies highlighting cost effectiveness and patient's perception regarding ease of use are required to confirm results. KEYWORDS: Differently abled patients, manual toothbrushes, electric toothbrushes, oral hygiene.

İşitme Engelli Öğrencilerle Çalışan Öğretmenlerin Mesleki Yeterliliklerine Yönelik Görüşlerinin Değerlendirilmesi

Introduction: Special education policy is based upon integration in Türkiye. Hence, the professional competencies of teachers working with hearing-impaired students in the field of hearing impairments have a prominent role in this policy. This study aims to identify the teacher needs for the teacher competency training program in hearing impairments to be developed for teachers of hearing-impaired students. Method: Qualitative research design was adopted in this study, and the data were collected by semi-structured interview on the professional knowledge and skills teachers need while teaching hearing-impaired students at different levels (primary, secondary, and high school) in the central districts of Sakarya. The data were analyzed by content analysis. Findings: Through the data, the main themes of knowledge about the hearing impaired, communication models and hearing aids, teaching methods and techniques, and academic and professional skills were unfolded. Discussion: In the literature, there are many studies that reveal the necessity and importance of needs analysis in studies to determine and develop teacher competencies and research results that are consistent with the findings of this study. Conclusion and Suggestions: As a result of this research, what teachers with hearing-impaired students state about the education of hearing impaired are as follows: Definitions, classification and developmental characteristics of hearing-impaired children, diagnosis and evaluation processes, educational approaches and program adaptation, individualized education program (IEP) development and implementation, material preparation and educational environments using technology, communication models, hearing aids and assistive technologies, environment adaptation and effective classroom management. In addition, it was found that teachers neither have sufficient knowledge about family education nor find themselves sufficient in issues regarding hearing-impaired students, so they wanted to receive training. Based on the study results, suggestions, such as supporting teachers with pre-service and in-service training and providing them with expert support, were made.

Effects of Cha-Cha Dance Training on Physical-Fitness-Related Indicators of Hearing-Impaired Students: A Randomized Controlled Trial.

(1) Background: The physical fitness (PF) of hearing-impaired students has always been an international research hotspot since hearing-impaired students have difficulty in social interactions such as exercise or fitness programs. Sports interventions are proven to improve the fitness levels of hearing-impaired students; however, few studies evaluating the influence of Cha-cha (a type of Dance sport) training on the PF levels of hearing-impaired students have been conducted. (2) Purpose: This study aimed to intervene in hearing-impaired children through 12 weeks of Cha-cha dance training, evaluating its effects on their PF-related indicators, thus providing a scientific experimental basis for hearing-impaired children to participate in dance exercises effectively. (3) Methods: Thirty students with hearing impairment were randomly divided into two groups, and there was no difference in PF indicators between the two groups. The Cha-cha dance training group (CTG, n = 15) regularly participated in 90-min Cha-cha dance classes five times a week and the intervention lasted a total of 12 weeks, while the control group (CONG, n = 15) lived a normal life (including school physical education classes). Related indicators of PF were measured before and after the intervention, and a two-way repeated-measures analysis of variance was performed. (4) Results: After training, the standing long jump (CONG: 1.556 ± 0.256 vs. CTG: 1.784 ± 0.328, p = 0.0136, ES = 0.8081), sit-and-reach (CONG: 21.467 ± 4.539 vs. CTG: 25.416 ± 5.048, p = 0.0328, ES = 0.8528), sit-ups (CONG: 13.867 ± 4.912 vs. CTG: 27.867 ± 6.833, p < 0.0001, ES = 2.4677) and jump rope (CONG: 52.467 ± 29.691 vs. CTG: 68.600 ± 21.320, p = 0.0067, ES = 0.6547) scores showed significant differences. (5) Conclusions: After 12 weeks of Cha-cha dance training for hearing-impaired students, the PF level of hearing-impaired students in lower-body strength, flexibility, core strength, and cardiorespiratory endurance were effectively improved; however, there was no significant change in body shape, upper-body strength, vital capacity, and speed ability.

The Effectiveness of Compassion-Focused Therapy on the Anxiety Level of Mothers with Hearing-Impaired Children

Background and Aim: One of the effects of having a disabled child on the parents is the experience of anxiety. Parents, especially mothers, blame themselves for their child’s problems and disabilities, and this anxiety can endanger the child’s mental health. The aim of this research was to investigate the effectiveness of compassion-focused therapy on the anxiety levels of mothers with hearing-impaired children.&#x0D; Methods: This study was a quasi-experimental study with a pretest/post-test design using a control group. The study population consists of all mothers with hearing-impaired children aged 30–40 years studying at Naghme School for the hearing-impaired in Yazd, Iran. A total of 30 mothers were selected using a purposive sampling technique and were randomly assigned into groups of control (n=15) and intervention (n=15). The intervention group received eight 90-minute sessions of compassion therapy, while the control group received no treatment. The Cattle Anxiety Questionnaire (CAQ) was used to collect data. Data were analyzed using descriptive and inferential statistics.&#x0D; Results: The mean and standard deviation of the pretest CAQ score was 63.25±7.70 for the intervention group. After the treatment, the mean and standard deviation of CAQ score was 44.02±6.32 for the intervention group. The results of ANCOVA showed an improvement in the cattle anxiety questionnaire scores of adolescents after intervention (p&lt;0.001).&#x0D; Conclusion: Compassion-focused therapy can improve the anxiety levels of parents with hearing-impaired children. Therefore, the use of this treatment method is recommended to specialists in this field.&#x0D; Keywords: Hearing-impaired; anxiety; compassion-focused therapy

Correlation of Conductive Hearing Impairment With Sizes of Adenoids in the Pediatric Age Group: An Observational Case-Control Study.

When adenoids enlarge and elicit symptoms it is referred to as symptomatic adenoids, which is a preventable cause of hearing loss and nasal obstruction in the pediatric age group. This study was done to correlate conductive hearing loss with the size of adenoids and to emphasize the importance of screening in the pediatric age group. An observational case-control study was conducted to analyze the degree of hearing impairment in children with adenoid hypertrophy. In total, 98 patients with at least one symptom of adenoid hypertrophy aged between 5 and <15 years were recruited. Those with conductive hearing loss were in thecase group and those with normal hearing were in the control group. Audiometry, tympanogram, X-ray, and fibreoptic nasal endoscopy were conducted and compared. The mean age of presentation of conductive hearing loss with adenoids was 7.67 years. The mean conductive hearing loss on audiometry was 31.69 dB. Tympanogram showed a type B curve in 40.81% of ears and type C in 26.53%. On X-ray nasopharynx, the majority of cases had grade III hypertrophy followed by grade II and grade IV.In nasal endoscopy, most cases had second-degree adenoid hypertrophy followed by third degree, first degree, and then fourth degree. The highest degree of hearing loss of 32-48 dB was present with fourth-degree adenoids. Conductive hearing loss was five times more in patients with third- and fourth-degree adenoids. In our study, adenoid hypertrophy has a positive correlation with conductive hearing loss in pediatric patients. So proper screening and early management should be done to prevent hearing loss in children.

Efficacy of Auditory Spatial Training with Real-Life Environmental Noise on Speech-in-Noise Intelligibility of Children with Hearing Loss

Purpose: This study aimed to determine whether auditory spatial training with real-life environmental noise would improve the speech-in-noise intelligibility of hearing-impaired children. Methods: Thirteen children with hearing loss participated in this study. We conducted an 8-week in-laboratory auditory spatial training. During the training, the target sentence and pre-recorded real-life environmental noise were spatially separated by 90°, and uncertainty about the location of the target and noise was given. To evaluate the efficacy of the training, sentence recognition with fluctuating and non-fluctuating noises was measured in a free sound-field condition, where the speech and noise sources were spatially separated and also co-located. The pre-training tests of sentence-in-noise recognition were performed twice with an interval of 6 weeks. The sentence-in-noise recognition test was also measured right after the 8-week training (post-training test) as well as 1 month after the completion of the training (retention test). In addition to the objective tests, the parents completed a subjective questionnaire on auditory behavior in everyday life before and after training. Results: There were no significant differences between the results of the two pre-training tests. The auditory spatial training significantly enhanced sentence-in-noise recognition in both spatially separated and co-located conditions at all signal-to-noise ratios, and the training efficacy was maintained until 1 month after the completion of the training. The parental subjective responses also showed positive changes after the training. Conclusion: An 8-week auditory spatial training could effectively enhance the speech-in-noise intelligibility of hearing-impaired children in spatialized as well as non-spatialized conditions.

Vocal health of parents of children with hearing assistive devices.

VH (Vocal health) is the need of the hour. VH of parents of children with hearing assistive devices (HAD) reveals a literature gap, during the habilitation process of their children. To explore the vocal health of parents of children with hearing assistive devices. This cross-sectional study was conducted at Riphah International University from September to December 2021. Study recruited N=384 parents of Hearing Impaired children (HIC) using HAD for at least two years, of both genders and aged 2-9 years using convenience sampling. Voice-related quality of life (V-RQOL), and vocal health Index (VHI) -10 were used for data collection. Data was analyzed on SPSS Version 25. Descriptive statistics, Anova and t-test were utilized to see difference between means of groups. P<0.05 shows significant-results. Parents of children using hearing assistive devices had excellent V-RQOL score in 350(91.14%) parents. There was no significant difference in V=RQOL as regards type of hearing assistive device use (p=0.102), laterality of device use (p=0.918) and degree of hearing loss (p=0.143). However, type of hearing loss revealed significant difference (p=0.021). Also VHI score revealed significantly (p=0.008) lower means in parents of children with cochlear implants. Current study concludes that the parents raising hearing impaired children with hearing assistive devices, possess good vocal health as determined by VHI and V-RQOL scores with only a very small number of parents reporting vocal symptoms.

THE RECOGNITION OF FACIAL EXPRESSIONS AND EMOTIONS IN DEAF AND HARD OF HEARING CHILDREN

The main goal of the paper is to examine comprehension of basic emotion and facial expression of children with hearing impairment. The research encompasses a sample of 66 respondents out of which 33 have non-damaged hearing and the remaining 33 respondents have hearing impairment. The age of respondents ranges, in chronological order, from 7 to 15 years. Recognition of emotions and facial expressions is being examined through 4 sets of tasks. The Emotion Recognition Test (ERT) is being used for evaluation, it has been adapted for the purpose of this paper and thereby adjusted for electronic usage via computer and internet. Through statistical processing of given data, following components have been calculated: minimal and maximum values, arithmetic mean, standard deviation, Wilcoxon Signed Ranks Test, Mann-Whitney U test, curvature test and flattening of distribution curve, t-test. Research results concluded that hearing impairment in children affects, with statistical significance, recognition and comprehension of facial expressions and emotions compared to their peers with no hearing impairment. The results were expected given the hearing condition and the consequences which hearing impairment creates. Children with hearing impairment possess poor vocabulary which affects comprehension of emotions. Statistically significant difference occurs among children with hearing impairments and recognition and comprehension of facial expression and emotions within situational context and isolated facial expressions.Key words: deaf children, comprehension of emotions, emotions of the deaf, facial expressions, hearing impairments.

Multidisciplinary Cognitive Function Assessment of Good versus Poor Performance in Children with Cochlear Implants: An Observational Cross-Sectional Study.

Introduction Despite the developing technology of cochlear implants (CIs), implanted prelingual hearing-impaired children exhibit variable speech processing outcomes. When these children match in personal and implant-related criteria, the CI outcome variability could be related to higher-order cognitive impairment. Objectives To evaluate different domains of cognitive function in good versus poor CI performers using a multidisciplinary approach and to find the relationship between these functions and different levels of speech processing. Methods This observational, cross-sectional study used the word recognition score (WRS) test to categorize 40 children with CIs into 20 good (WRS/65%) and 20 poor performers (WRS < 65%). All participants were examined for speech processing at different levels (auditory processing and spoken language) and cognitive functioning using (1) verbal tests (verbal component of Stanford-Binet intelligence [SBIS], auditory memory, auditory vigilance, and P300); and (2) performance tasks (performance components of SBIS, and trail making test). Results The outcomes of speech processing at different functional levels and both domains of cognitive function were analyzed and correlated. Speech processing was impaired significantly in poor CI performers. This group also showed a significant cognitive function deficit, in which the verbal abilities were more affected (in 93.5%) than in the good performers (in 69.5%). Moreover, cognitive function revealed a significant correlation and predictive effect on the CI speech outcomes. Conclusion Cognitive function impairment represented an important factor that underlies the variable speech proficiency in cochlear-implanted children. A multidisciplinary evaluation of cognitive function would provide a comprehensive overview to improve training strategies.