Meaningful Use Of Speech Scale Research Articles

Time course from cochlear implant surgery to non-use for congenitally deaf recipients implanted as children over ten years ago.

To determine the time-course from first cochlear implantation to non-use, to characterise non-users' receptive and expressive communication, and document known risk factors for inconsistent use, for congenitally deaf non-users of cochlear implants implanted as children at least ten years ago. Retrospective service evaluation. All congenitally deaf patients who received a first cochlear implant as children at least ten years ago at a regional service, and were currently non-users, were identified. They were characterised in terms of ages at implantation and non-use, known risk factors for inconsistent CI use or CI non-use, and outcome measures were the Meaningful Auditory Integration Scale (MAIS) and Meaningful Use of Speech Scale (MUSS) scores. Seventeen patients met the inclusion criteria. They were implanted from 1990 to 2006. Median age at implantation was 4 years (range: 2-11), median age at non-use was 17 years (range: 9-31), and median duration of use was 8.5 years (range: 4-25). All used sign or gesture as their primary expressive and receptive communication modes. In addition, each child had at least one other known risk factor for inconsistent CI use. At 3 years post-implantation, mean Parent-rated MAIS scores were 76.5% (N = 14), and mean MUSS scores were 43.1% (N = 9). This cohort included cases where CI use was rejected following longer periods of time than previously reported, highlighting a need for long-term support, particularly around the ages of life transitions. Studies conducted when the earliest cohort of paediatric CI users were younger, and studies reliant on parent or patient reports, may under-estimate long-term non-use rates. No non-users were identified among congenitally-deaf children implanted 10-15 years ago. Further research is warranted to explore relationships between risk factors, including communication mode, and non-use to inform expectation setting and candidacy selection.

Electrode-Modiolus Distance Affects Speech Perception for Lateral Wall Electrodes.

The goal of this study was to use cone-beam computed tomography to locate the electrode-modiolus distance (EMD) and correlate this with speech perception in cochlear implant (CI) recipients of the 31.5-mm lateral wall (LW) electrode arrays. Retrospective review. Forty-five child CI recipients with prelingual profound sensorineural hearing loss of inserted 31.5-mm LW arrays listening with a CI-alone device. Stepwise forward multiple linear regression was performed to control and reduce the variability in implant performance to determine whether EMD affects speech perception. Electrode location (angular insertion depth [AID], EMD), together with the electrode impedance (EI), surgical approach, sex, CI age, and preimplant hearing aid usage were estimated as independent variables. The dependent variables were the Meaningful Use of Speech Scale (MUSS) and parents' evaluation of children's aural/oral performance (PEACH) assessed with the CI alone at 12 months postactivation. EMD and CI age were predictive variables for PEACH/MUSS. A negative correlation was found between AID and EMD (r = -0.56, p < 0.01), whereas EMD had a moderately positive correlation with EI (r = 0.32, p < 0.01). The best "location-related" predictor of postoperative speech perception was EMD with a 31.5-mm array among CI-alone users.

Correlation between cortical auditory evoked potential and auditory speech performance in children with cochlear implants.

This study aimed to explore the correlation between the characteristics of cortical auditory evoked potential (CAEP) of children with cochlear implants (CIs) and auditory and speech rehabilitation performance by an objective evaluation technique and subjective auditory and speech skills measurements. All participants were recruited from Beijing Children's Hospital, Beijing, China. 19 children with CIs had their responses to the CAEP and MMN recorded. The LittlEARs® Auditory Questionnaire (LEAQ), Categories of Auditory Performance (CAP), Speech Intelligibility Rating Scale (SIR), Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS), and Meaningful Use of Speech Scale (MUSS) measures were taken to assess the children's speech and hearing abilities. P1 and MMN of CAEP were negatively related to the duration of CI usage. The duration of CI usage and scores of auditory-verbal assessment questionnaires all showed significant relationships. Additionally, scores of these questionnaires were significantly inversely associated with the latency of P1 and MMN. P1 and MMN could be used as objective methods to evaluate the effectiveness of hearing and speech rehabilitation in children with CIs. In particular to those who cannot give effectively feedback of auditory and verbal effects, these methods might have a certain guiding significance.

Psychometric properties of the Arabic version of the meaningful use of speech scale (Arabic MUSS)

PurposeTo examine the construct, discriminative, and predictive validity, and the test-retest reliability of the Arabic Meaningful Use of Speech Scale (MUSS).MethodsParents of 102 children with cochlear implantation (CI) with a matching control group of 102 children with normal hearing completed the Arabic-MUSS scale. A random subsample of 30 parents was interviewed after two weeks to examine the test-retest reliabilityResultsthe construct validity of the Arabic-MUSS was established by exploratory factor analysis that yielded a unidimensional scale and explained a total of 92.48% of the variance in the total score of the Arabic-MUSS. The internal consistency of the scale was excellent with Cronbach’s alpha = 0.975. The Arabic-MUSS discriminative validity was supported by the significant difference between the total score of children with CI and children with normal hearing (p < 0.0001). The Arabic-MUSS has a moderate predictive validity as demonstrated by the moderate correlation between the total score and the time since cochlear implantation (p < 0.001). The Arabic-MUSS has excellent test-retest reliability.ConclusionThe Arabic-MUSS is a valid and reliable measure that can be used to guide plans for auditory rehabilitation and monitor the progress of children with cochlear implantation over time.IMPLICATIONS FOR REHABILITATIONThe Arabic-Meaningful Use of Speech Scale is a valid and reliable parent-report assessment.The Arabic-Meaningful Use of Speech Scale evaluates functional speech in children with cochlear implantation.Clinicians can use the Arabic- Meaningful Use of Speech Scale to plan and monitor the progress of auditory rehabilitation programs.

A 3-Year Follow-Up and Radiological Analysis of Cochlear Implantation Patients with Cochlear Nerve Deficiency and Modiolar Deficiency-Type Malformations.

Cochlear nerve deficiency (CND) is often combined with modiolar deficiency-type inner ear malformations, which cause variable cochlear implantation (CI) outcomes. We aimed to assess the postoperative development of auditory and speech perception in CND patients with modiolar deficiency-type malformations after 3 years of follow-up to determine the factors correlated with CI outcomes. Sixty-seven CND patients with modiolar deficiency-type malformations who underwent CI surgery were retrospectively reviewed. Modiolar deficiency-type malformations included common cavity (CC), cochlear hypoplasia (CH) (including CH-I and CH-II) and incomplete partition-I (IP-I). Categorical auditory performance (CAP) and the infant-toddler meaningful auditory integration scale (MAIS) were used to assess auditory ability. The speech intelligibility rating (SIR) and meaningful use of speech scale (MUSS) were used to assess the speech intelligibility of these CI patients. The CI outcomes were evaluated at 0, 12, 24 and 36 months after implant activation. All patients demonstrated improvements in auditory ability and speech intelligibility after CI. There were no significant differences in CI outcomes at any time point according to the malformation type. The number of nerve bundles within the internal auditory canal (IAC) showed significant differences at 12, 24 and 36 months after CI ( p < 0.05). Patients with one nerve bundle had relatively poor CI outcomes. CND patients with modiolar deficiency-type malformations showed continuous improvement in auditory and speech abilities after CI. Compared with malformations, the number of nerve bundles should be given more attention when selecting the side for CI.

Simultaneous Bilateral Cochlear Implantation in Very Young Children Improves Adaptability and Social Skills: A Prospective Cohort Study.

To investigate the value of using the Gesell Development Diagnosis Scale (GDDS) to predict developmental outcomes in very young children who undergo simultaneous bilateral cochlear implantation. In this prospective cohort study, a repeated-measures investigation was conducted in a tertiary referral hospital. A total of 62 children receiving simultaneous bilateral cochlear implantations were enrolled from April 2017 to August 2018. They were divided into 2 groups depending on the operative age: "Infants" group (6 to 12 months, N = 38) or "Children" group (12 to 36 months, N = 24). Data on the surgical outcomes, auditory development, speech production, and developmental indicators were collected until 2 years after the initial fitting. The primary outcome measure was the GDDS, a neuropsychological development examination. Secondary outcomes included the following: complication rate, aided pure-tone average, Infant-Toddler Meaningful Auditory Integration Scale, Categories of Auditory Performance-II, Meaningful Use of Speech Scale, Speech Intelligibility Rating, and the LittlEARS Auditory Questionnaire. The mean ages at implantation in infants and children groups were 9.2 ± 1.17 and 16.6 ± 3.60 months, respectively. Significant differences were found in the social skills ( p = 0.001) and adaptability ( p = 0.031) domains of GDDS. The younger the age of bilateral cochlear implants surgery, the higher developmental quotient of language, social skills, and adaptability the child could achieve after 2 years. The complication rates in the infants and children groups were 0% versus 2.1% ( p = 0.57). There was no surgical complication in the infants group. In the children group, 1 case with enlarged vestibular aqueduct and Mondini malformation had a receiver-implant misplacement on the right side (2%, 1/48). In the two groups, auditory performance and speech production had improved similarly. In the infants group, social skills developmental quotient at baseline had a significant positive relationship with Meaningful Use of Speech Scale after 2 years. Simultaneous bilateral cochlear implantation in younger children improves adaptability and social skills. GDDS is a sensitive tool of evaluating short-term effect of bilateral cochlear implants in neuropsychological development and constitutes a reliable predictor of speech production for the very younger pediatric cochlear implant users.

Assessment of the correlation between residual hearing and audiologic outcomes after cochlear implantation in patients with cochlear nerve deficiency.

ObjectiveThis study aimed to assess the correlation between residual hearing and audiologic outcomes after cochlear implant (CI) surgery in patients with cochlear nerve deficiency (CND).MethodsThis retrospective study included 57 patients with CND who underwent CI surgery. Patients were divided into four groups according to hearing level (80–95, 95–110, 110–120, and >120 dB) and three groups according to residual hearing (entire spectrum hearing, partial spectrum hearing, and no spectrum hearing) based on the measured response at each frequency. Auditory performance (categorical auditory performance [CAP], Infant–Toddler Meaningful Auditory Integration Scale [IT‐MAIS]) and speech perception (speech intelligibility rating [SIR] and meaningful use of speech scale [MUSS]) were assessed before and 2 years after the surgery.ResultsForty‐seven (82.5%) patients had complete or total hearing loss (≥95 dB) and 17 (29.8%) had no spectrum hearing before CI surgery. Twenty‐nine (50.9%) patients did not exhibit residual hearing at 4 kHz. All patients demonstrated an improvement in auditory performance and speech perception: the CAP score in the 80–95 dB group was significantly higher than that in the 110–120 and >120 dB groups, and the entire spectrum hearing group showed significantly higher CAP, SIR, and IT‐MAIS scores than the partial spectrum hearing group and significantly higher CAP, SIR, IT‐MAIS, and MUSS scores than the no spectrum hearing group.ConclusionFor patients with CND, residual hearing, especially high‐frequency residual hearing, was poor and postoperative audiologic outcomes were significantly associated with the range of residual hearing.Level of Evidence4

Residual Hearing Improves Early Auditory Perception and Speech Intelligibility in Mandarin-Speaking Children with Cochlear Implants.

Background:To investigate the relationship between residual hearing and early auditory speech performance in Mandarin-speaking children with cochlear implants.Methods:Twenty-four prelingually deaf children implanted with a cochlear implants participated in the study. Auditory performance and speech intelligibility were longitudinally evaluated by categories of auditory performance, infant-toddler meaningful auditory integration scale/meaningful auditory integration scale, speech intelligibility rating, and meaningful use of speech scale. According to the postoperative pure tone average threshold, children were grouped as “better” and “worse” residual hearing.Results:Better hearing preservation was observed in 7 children (29.2%) and worse preservation in 17 children (70.8%). The scores of categories of auditory performance, infant-toddler meaningful auditory integration scale/meaningful auditory integration scale, speech intelligibility rating, and meaningful use of speech scalewere higher in children with better residual hearing. The residual hearing level was significantly associated with the performance of meaningful use of speech scale (P = .004), as well as the performance of speech intelligibility rating (P = .049).CONCLUSION:The present study showed that children with better residual hearing exhibited advantages in the early auditory and speech outcomes. The study highlighted the effects of residual hearing on early auditory performance and speech intelligibility development in Mandarin-speaking children with cochlear implants.

Machine Learning-Based Prediction of the Outcomes of Cochlear Implantation in Patients With Cochlear Nerve Deficiency and Normal Cochlea: A 2-Year Follow-Up of 70 Children.

Cochlear nerve deficiency (CND) is often associated with variable outcomes of cochlear implantation (CI). We assessed previous investigations aiming to identify the main factors that determine CI outcomes, which would enable us to develop predictive models. Seventy patients with CND and normal cochlea who underwent CI surgery were retrospectively examined. First, using a data-driven approach, we collected demographic information, radiographic measurements, audiological findings, and audition and speech assessments. Next, CI outcomes were evaluated based on the scores obtained after 2 years of CI from the Categories of Auditory Performance index, Speech Intelligibility Rating, Infant/Toddler Meaningful Auditory Integration Scale or Meaningful Auditory Integration Scale, and Meaningful Use of Speech Scale. Then, we measured and averaged the audiological and radiographic characteristics of the patients to form feature vectors, adopting a multivariate feature selection method, called stability selection, to select the features that were consistent within a certain range of model parameters. Stability selection analysis identified two out of six characteristics, namely the vestibulocochlear nerve (VCN) area and the number of nerve bundles, which played an important role in predicting the hearing and speech rehabilitation results of CND patients. Finally, we used a parameter-optimized support vector machine (SVM) as a classifier to study the postoperative hearing and speech rehabilitation of the patients. For hearing rehabilitation, the accuracy rate was 71% for both the SVM classification and the area under the curve (AUC), whereas for speech rehabilitation, the accuracy rate for SVM classification and AUC was 93% and 94%, respectively. Our results identified that a greater number of nerve bundles and a larger VCN area were associated with better CI outcomes. The number of nerve bundles and VCN area can predict CI outcomes in patients with CND. These findings can help surgeons in selecting the side for CI and provide reasonable expectations for the outcomes of CI surgery.

Analysis of Long-Term Cochlear Implantation Outcomes and Correlation With Imaging Characteristics in Patients With Common Cavity Deformity.

ObjectTo investigate the long-term development of auditory and speech in patients with common cavity deformity (CCD) after cochlear implantation (CI) and its relationship to imaging characteristics.MethodsTwenty-three CCD patients and 59 age- and sex-matched CI children with normal inner ear structure were recruited. The auditory and speech development of these two groups were evaluated at 0, 1, 3, 6, 12, and 18 months after CI activation using four parent reports questionnaires [Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR), Meaningful Auditory Integration Scale/Infant-Toddler Meaningful Auditory Integration Scale (MAIS/ITMAIS), and Meaningful Use of Speech Scale (MUSS)]. Computed tomography-based 3-dimensional reconstruction of the surgical side of 18 CCD children was performed, the volume and surface area were calculated. Correlation analysis was performed on the imaging performance and post-operative outcomes.ResultsThe percentages of MAIS/IT-MAIS scores and CAP scores at different evaluation time points are significantly different (p < 0.05). When comparing SIR results across time points, significant growth was observed in most of the comparisons. In addition, significant differences (p < 0.05) are observed among the percentages of MUSS scores at different time points except the comparison between 0 and 1 month after CI activation. Patients in the CCD group had poorer auditory and speech performances at different stages after CI compared with those in the control group. According to the reconstruction of CCD patients, the volume ranged from 12.21 to 291.96 mm3; the surface area ranged from 27.81 to 284.7 mm2. When the lumen surface area was <190.45 mm2 or the volume was <157.91 mm3, the survival time for CCD children to achieve a CAP score of 4 after CI was significantly shorter.ConclusionCochlear implantation are less effective in CCD patients than in patients with normal inner ear structures, but they can still achieve significant improvement post-operatively. The morphology and size of the inner ear vary in CCD patients, which reflects the degree of inner ear development influences the outcome after CI surgery.

Different modes of cochlear implantation in children: a comparative study on hearing and speech rehabilitation effects.

To study the effectiveness of unilateral cochlear implantation, binaural-bimodal hearing devices, and bilateral cochlear implantation in children with inner-ear malformation. This study comprised 261 patients who were allocated to inner-ear malformation or control groups. Twenty-four months after surgery, aided sound-field thresholds were tested, and the Meaningful Auditory Integration Scale, Infant-Toddler Meaningful Auditory Integration Scale, Meaningful Use of Speech Scale, Categories of Auditory Performance scale and Speech Intelligibility Rating test were completed. Aided sound-field thresholds were significantly better for bilateral cochlear implantation patients than for unilateral cochlear implantation or binaural-bimodal hearing device patients. There was no significant difference in Meaningful Auditory Integration Scale, Infant-Toddler Meaningful Auditory Integration Scale, or Categories of Auditory Performance scores among the three groups. The binaural-bimodal hearing device patients outperformed unilateral cochlear implantation patients on both Meaningful Use of Speech Scale and Speech Intelligibility Rating scores. No statistical difference was observed between the two subgroups. Children who received bilateral cochlear implants have the best auditory awareness in a quiet environment. Children with binaural-bimodal hearing devices have better voice control and verbal skills than unilateral cochlear implantation patients, and people are more likely to understand them. Children with inner-ear malformations benefit from cochlear implantation.

Outcome of Cochlear Implantation in Children with Auditory Neuropathy-A Dual Case Study

Objectives: The aim of this study is to compare the outcome of cochlear implantation in two pediatric auditory neuropathy cases. Methods: Two cases with auditory neuropathy were taken. Case 1 was 10 year old male. Case 2 was 11 year old male. In preoperative assessment both have bilateral severe to profound sensory-neural hearing loss. Case 1 was implanted by MED-EL using sonata Ti100 opus 2 processor. Case 2 was implanted using MED-EL using sonata Ti100 opus 2 processor. Both cases were given auditory verbal therapy. Both cases attended auditory verbal therapy for a period of 2 years. In postoperative assessment for each individual subject, electrically evoked compound action potentials (ECAPs), electrically evoked stapedius reflex threshold (ESRT), and electrically evoked auditory brainstem response (EABR) thresholds were determined. The following questionnaire extended receptive expressive emergent language scale (E-REELS) , Categories of Auditory Performance (CAP) score, Speech Intelligibility Rating (SIR) scale, Meaningful Auditory-Integration Scale (MAIS) and Meaningful Use of Speech Scale (MUSS) are scales were administered. Results: In the postoperative assessment, ECAP, ESRT, EABR, MUSS, MAIS shows that case 1 with auditory neuropathy have better performance than case 2. Conclusion: It is essential that all possible complications and postoperative performance should be considered in cochlear implantation for auditory neuropathy individuals

Evaluation of the language development of children with cochlear implant users living in a multilingual environment

ObjectiveTo evaluate the effect of second language exposure on Turkish speaking skills in cochlear implant (CI) users. MethodsChildren living in mono and bilingual families, who underwent unilateral cochlear implant due to congenital severe to profound, or profound hearing loss, were examined. The fifty six children with a chronological age younger than 8 and a language age of 2–6 years were included the study. The Denver II Developmental Screening Test was used for identifying of pre-implant speech and development. The duration of implant use was also documented. Languages spoken at the patients' homes were divided into 4 categories: T/K: Predominantly Turkish/Kurdish, K/T: Predominantly Kurdish/Turkish, T/T: Just Turkish, A/T: Predominantly Arabic/Turkish. The CAP (Categories of Auditory Performance), SIR (Speech Intelligibility Rating), The Turkish Version Test of The Early Language Development (TELD-3:T),. The IT-MAIS (Infant Toddler Meaningful Auditory Integration Scale), MUSS (Meaningful Use of Speech Scale) were used to evaluate the language development of the patients. Changes in IT-MAIS and MUSS scores in the last two years were also evaluated. ResultsThe all children received their implants before age of 6 years. The average duration of cochlear implant use of children was 38,43 ± 11,64 months. The mean pre-implant speech age was 6,8 ± 2,13 months. There was no significant difference between the groups in terms of the CAP and SIR scores. In TELD-3:T scores, there was no significant difference between the groups except for the receptive raw scores. The Arabic/Turkish group had significantly lower receptive raw scores. This group also had significantly lower mother educational level.In IT-MAIS and MUSS scores, no significant difference was found between the groups. ConclusionsOur study supports the opinion that exposure to a second language at home does not affect the acquisition of the language of education in children using CI.

Comparison of residual hearing preservation and auditory based performance after paediatric cochlear implantation by round window insertion versus cochleostomy technique: an ambispective cohort study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Cochlear implantation (CI) has revolutionized the treatment of sensorineural deafness. The aim of the study was to compare auditory based performance in cochlear implants who underwent round window insertion and cochleostomy.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Ambispective cohort study was done among the children who underwent perilingual cochlear implant in a tertiary care hospital for period of 1 year. Children who satisfied the inclusion criteria were selected and randomly subdivided into 2 groups: group A- round window insertion and group B-cochleostomy. Pre- and post-operative pure tone average (PTA) and residual hearing preserved were evaluated among the cochleostomy and round window insertion groups separately. Post-operatively, children were evaluated, from three months to 1 year from the activation of cochlear implant, with the use of scores such as Category of Auditory Performance (CAP), Meaningful Auditory Integration Scale (MAIS), Speech Intelligibility rating (SIR) and Meaningful use of speech scale (MUSS score) to measure speech production skills by auditory verbal therapist. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; A total of 80 patients were included in the study. Complete hearing preservation (within 10 dB) was significantly high in round window insertion group compared to cochleostomy technique (p&amp;lt;0.001). None the subjects had complete loss of residual hearing. On evaluating the post CI performance, MAIS score in the round window insertion group (9.34, 18.21, 27.79) were significantly better compared to cochleostomy group during the 3 months, 6 months and 12 months follow-up.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Round window insertion technique is significantly more successful in complete hearing preservation at low frequencies compared to cochleostomy technique. Among the auditory scores, only MAIS in the round window insertion group was found to be significantly better compared to cochleostomy group.&lt;/p&gt;

A review of the outcomes of children with designated additional needs receiving cochlear implantation for severe to profound hearing loss

Objective To evaluate one year outcomes of children with additional needs receiving cochlear implantation at the Yorkshire Auditory Implant Service (YAIS) over a ten-year period. Methods Retrospective chart review yielded 270 children who received cochlear implants (CIs) at YAIS between 2007 and 2017; 49 children were classified as having additional needs. Audiological performance scales (Meaningful Auditory Information Scale (MAIS), Meaningful Use of Speech Scale (MUSS), Listening in Progress (LIP), Categories of Auditory Performance (CAP), and Speech Intelligibility Rating Scale (SIR)) were analysed pre- and 12 months post-implantation. Comparison was made with children without additional needs. Results Children with additional needs demonstrated significantly lower pre-implantation audiological performance in MAIS, LIP, and MUSS (P <0.05). Despite showing improvement, children with additional needs consistently achieved lower scores in all metrics at one year (P < 0.05). Similarly, the rate of change was statistically significantly lower in children with additional needs. Conclusion All children were able to gain access to sound following CI. Improvements were seen in all outcome measures especially in the MAIS, CAP and LIP whereas limited improvement was seen in measures assessing speech production and improvement. The rate of improvement was statistically significantly lower in children with additional needs.

Auditory, Speech and Language Development in Cochlear Implant Children: A One Year Longitudinal Study.

The advent of Cochlear Implants (CI) has bought with it, the goal of spoken language performance for severe-profound sensori-neural hearing loss (SNHL) as par with the normal hearing listeners. The aim of this study was to evaluate the outcome of paediatric cochlear implantation in auditory and speech skills below the age of 5years. The present study consisted of 50 childrens. Auditory skills were assessed in terms of audiometric thresholds and localization abilities. Speech - Language skills were measured using; Categories of Auditory Performance -CAP; Meaningful Use of Speech Scale - MUSS; Meaningful Auditory Integration Scale - MAIS and Speech intelligibility Rating - SIR. Hearing thresholds obtained from all the subjects for pre implant and post implant conditions of 3rd, 6th, 9th, 12th month conditions, evidenced a high significant (p < 0.001) improvement across all test frequencies 500, 1000, 2000 and 4000Hz. There was also a statistically significant difference across successive measurements of auditory and speech skills, as determined by ANOVA (F (4, 245) = 151.33, p < 0.001 for CAP; F (4, 245) = 89.636, p < 0.001 for SIR; F (4, 245) = 812.282 p < 0.001 for MAIS and F(4, 245) = 435.677 p < 0.001 for MUSS). Auditory localization abilities were also improved considerably over a period of one year. The present study added the evidence to the literature that cochlear implants significantly improved the hearing ability of children with severe-to-profound hearing loss. This study also demonstrated that, children were better able to make use of the auditory information perceived through the implant.

Bimodal Stimulation in Children With Bilateral Profound Sensorineural Hearing Loss: A Suitable Intervention Model for Children at the Early Developmental Stage.

To evaluate the auditory and speech benefit of bimodal stimulation for prelingual deafened cochlear implantation recipients. Retrospective and comparative study. Tertiary referral center. Fifty-six children with bilateral prelingual profound sensorineural hearing loss were enrolled, including 28 consecutive children with unilateral cochlear implantation (CI group), and 28 consecutive children with bimodal stimulation (BI group) who used an additional hearing aid (HA) in the contralateral ear. Hearing assessments included the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) and Categories of Auditory Performance (CAP). Speech evaluations included the Meaningful Use of Speech Scale (MUSS), and Speech Intelligibility Rating (SIR). These measurements were evaluated at the first mapping of cochlear implants and 0.5, 1, 3, 6, 12, 18, 24 months after. Data were analyzed by repeated measures analysis. The mean ages of BI and CI groups were similar (17.6 ± 6.87 vs 19.0 ± 8.10 months, p = 0.497). The initial scores for hearing and speech assessments showed no differences between the two groups, apart from IT-MAIS (2.46 ± 0.631 in BI group vs 0.50 ± 0.279 in CI group, p = 0.004). The auditory and speech development over time were different in the two groups as seen in IT-MAIS (p < 0.001), CAP (p = 0.029), MUSS (p < 0.001), and SIR (p < 0.001). A continuing but stable difference was observed in CAP, MUSS, and SIR at 3, 18, and 12 months after the first mapping, respectively. In addition, the BI group had better IT-MAIS scores at 3 and 6 months compared with the CI group; however, the difference was not significant after 12 months. Bimodal stimulation is beneficial for prelingually deafened CI recipients who have minimal contralateral residual hearing when bilateral CIs are not available. Hearing aid use in the contralateral ear might be recommended for children after unilateral cochlear implantation to facilitate the development of auditory and speech skills.

Long-term evaluation of development in patients with bilateral microtia using softband bone conducted hearing devices

ObjectiveThe ability of early intervention with softband bone conducted hearing device (BCHD) to ensure normal development of speech, language and psychosocial situations remains undetermined. We aimed to evaluate auditory and speech development, as well as psychosocial situations of children with bilateral microtia fitted with a softband BCHD for 3–5 years. MethodsThe study included 53 patients with bilateral microtia and 53 sex- and age-matched children with normal hearing. Auditory development was evaluated using the Meaningful Auditory Integration Scale (MAIS) and Categories of Auditory Performance (CAP). Speech Intelligibility Rating (SIR) and Meaningful Use of Speech Scale (MUSS) were used to assess speech development. The psychometric properties of these patients were evaluated using Achenbach's Child Behavior Checklist (CBCL), and subjective benefits were measured using the Glasgow Children's Benefit Inventory (GCBI) questionnaire. ResultsThe average unaided and aided hearing thresholds measured using VRA were 73.8 ± 5.1 dB HL and 30.5 ± 6.0 dB HL, respectively. The total MAIS scores of the patients were 89.6 ± 9.6% and 93.0 ± 8.8% of normal hearing children at the last follow-up. The CAP scores of the two groups were 6.5 ± 1.3 and 6.9 ± 0.3, respectively. The mean MUSS score of the patients and the control group were 31.9 ± 7.0 and 34.3 ± 6.0, respectively. The mean SIR score of the two groups were 4.6 ± 0.7 and 4.8 ± 0.4. CBCL found that only two patients could be considered problematic psychosocially. The average benefit score on the GCBI was 32.9 ± 29.3. ConclusionsSoftband BCHD significantly improved auditory development in patients with bilateral microtia, with speech development reaching the level of normal hearing peers. No significant behavioral problems were found in the patients, with subjective evaluations showing that softband BCHD improved patient quality of life.

Clinical evaluation of cochlear implantation in children younger than 12 months of age.

ABSTRACTImportanceCochlear implantation (CI) is an effective therapy for patients with severe to profound sensorineural hearing loss. It remains controversial whether children younger than 12 months of age should undergo CI.ObjectiveTo evaluate the safety and effectiveness of CI in children younger than 12 months of age.MethodsWe performed a retrospective study of clinical data of pediatric patients younger than 12 months of age who underwent CI and were followed up for 1 to 2 years. Patients’ developmental levels were evaluated by the Gesell score before CI. Intraoperative and postoperative complications were recorded to evaluate the safety of CI. Auditory and speech abilities were scored by the LittlEARS® auditory questionnaire (LEAQ), categories of auditory performance (CAP), speech intelligibility rating (SIR), infant‐toddler meaningful auditory integration scale (IT‐MAIS), and meaningful use of speech scale (MUSS) at 1, 2, 3, 6, 9, and 12 months after CI. The associations between clinical characteristics before CI and postoperative scores at 1 year after CI were analyzed by the linear mixed‐effects model.ResultsEighty‐nine children (47 boys and 42 girls) were included in this study (mean age at CI, 9.2 ± 1.6 months). Sixteen patients were diagnosed with cochlear malformation and 16 underwent bilateral CI. No severe complications occurred in any patients. The mean developmental quotient of the Gesell score was 78.00 ± 10.03. The median LEAQ scores were 0, 5, 10, 16, 22, 26 and 30 before and at 1, 2, 3, 6, 9, and 12 months after CI, respectively. These findings implied that the LEAQ score greatly improved in the first year after CI. The overall CAP, SIR, IT‐MAIS, and MUSS scores also increased with increasing duration after CI. No significant associations were detected between clinical characteristics (age, sex, implant number, pre‐CI Gesell score, and inner ear malformation) and LEAQ outcomes at 12 months after CI.InterpretationWith increasing duration after CI, auditory and speech behavior dramatically improve in young children. Our findings indicate that CI is feasible for children younger than 12 months of age.

A Retrospective Clinical Audit of Outcomes of Cochlear Implantation in Children with Multiple Disabilities in Comparison with Normal Implantees: A South Indian Experience

AimsCochlear implantation (CI) is established as a standard remedy for children with congenital bilateral profound hearing loss to attain hearing perception and thereby develop speech and language. A subgroup includes children with multiple disabilities in whom the implant helps to improve their quality of life and also of their families via enhanced communication skills. Cochlear implants today form an integral part of their multi-handicap rehabilitation process.Material and MethodsA retrospective cohort study was carried out on children with and without multiple handicaps who have received cochlear implantation at the cochlear implant clinic of MERF, Chennai, India over the past decade. Category of Auditory Performance (CAP) scores, Speech Intelligibility Rating (SIR) scores, and also Meaningful Auditory-Integration Scale (MAIS) and Meaningful Use of Speech Scale (MUSS) scores were compared at set time frequencies of 6 months and 12 months post-implantation between the two groups of implanted children.ResultsAll the four CAP, SIR, MAIS and MUSS scores showed improvement over time with auditory and speech therapy in both groups of children as reflected by the improvement in their quality of life. The normative group of implantees showed better improvement compared to the group of children with multiple disabilities.ConclusionIntensive habilitation is essential especially for children with multiple disabilities who have received cochlear implantation in which their special needs are addressed individually and optimised for the best outcome. The study shows that restoration of the special sense of hearing helps as a remedy to alleviate their other multi-handicaps to a notable extent.