Pediatric Cochlear Implant Recipients Research Articles

Electric Charge Requirements of Pediatric Cochlear Implant Recipients Enrolled in the Childhood Development After Cochlear Implantation Study

To evaluate mapping characteristics of children with cochlear implants who are enrolled in the Childhood Development After Cochlear Implantation (CDACI) multicenter study. Longitudinal evaluation during 24 months of speech processor maps of children with cochlear implants prospectively enrolled in the study. Six tertiary referral centers. One hundred eighty-eight children enrolled in the CDACI study who were 5 years old or younger at the time of enrollment. Of these children, 184 received unilateral implants, and 4 received simultaneous bilateral implants. Children attended regular mapping sessions at their implant clinic as part of the study protocol. Maps were examined for each subject at 4 different time intervals: at device activation and 6, 12, and 24 months postactivation. Mean C/M levels (in charge per phase) were compared for 4 different time intervals, for 3 different devices, for 6 different implant centers, and for children with normal and abnormal cochleae. All 3 types of implant devices demonstrate significant increases in C/M levels between device activation and the 24-month appointment. Significant differences in mean C/M levels were noted between devices. Children with cochlear anomalies demonstrate significantly greater C/M levels than children with normal cochleae. The CDACI study has enabled us to evaluate the mapping characteristics of pediatric patients who use 3 different devices and were implanted at a variety of implant centers. Analysis of such data enables us to better understand the mapping characteristics of children with cochlear implants.

Imitative Production of Rising Speech Intonation in Pediatric Cochlear Implant Recipients

This study investigated the acoustic characteristics of pediatric cochlear implant (CI) recipients' imitative production of rising speech intonation, in relation to the perceptual judgments by listeners with normal hearing (NH). Recordings of a yes-no interrogative utterance imitated by 24 prelingually deafened children with a CI were extracted from annual evaluation sessions. These utterances were perceptually judged by adult NH listeners in regard with intonation contour type (non-rise, partial-rise, or full-rise) and contour appropriateness (on a 5-point scale). Fundamental frequency, intensity, and duration properties of each utterance were also acoustically analyzed. Adult NH listeners' judgments of intonation contour type and contour appropriateness for each CI participant's utterances were highly positively correlated. The pediatric CI recipients did not consistently use appropriate intonation contours when imitating a yes-no question. Acoustic properties of speech intonation produced by these individuals were discernible among utterances of different intonation contour types according to NH listeners' perceptual judgments. These findings delineated the perceptual and acoustic characteristics of speech intonation imitated by prelingually deafened children and young adults with a CI. Future studies should address whether the degraded signals these individuals perceive via a CI contribute to their difficulties with speech intonation production.

Speech Intelligibility of Pediatric Cochlear Implant Recipients With 7 Years of Device Experience

Speech intelligibility of 24 prelingually deaf pediatric cochlear implant (CI) recipients with 84 months of device experience was investigated. Each CI participant's speech samples were judged by a panel of 3 listeners. Intelligibility scores were calculated as the average of the 3 listeners' responses. The average write-down intelligibility score was 71.54% (SD = 29.89), and the average rating-scale intelligibility score was 3.03 points (SD = 1.01). Write-down and rating-scale intelligibility scores were highly correlated (r = .91, p < .001). Linear regression analyses revealed that both age at implantation and different speech-coding strategies contribute to the variability of CI participants' speech intelligibility. Implantation at a younger age and the use of the spectral-peak speech-coding strategy yielded higher intelligibility scores than implantation at an older age and the use of the multipeak speech-coding strategy. These results serve as indices for clinical applications when long-term advancements in spoken-language development are considered for pediatric CI recipients.

Acquisition of rising intonation in pediatric cochlear implant recipients—a longitudinal study

This study examined how cochlear implant (CI) devices can facilitate pediatric users' post-implant acquisition of rising intonation of speech. Participants were 24 prelingually deafened individuals who received their implants from 2.5 to 11 years of age. A target utterance “Are you ready?” was imitatively produced by each of the participants following an examiner's model on an annual basis (up to 10 years post-implantation). Ten normal-hearing listeners perceptually judged these utterances ( N=173) regarding whether the perceived utterances had an intonation of non-rise, partial rise, or full-rise. Listeners also judged each utterance with respect to its intonation contour appropriateness and speech intelligibility. Results indicated that pediatric CI recipients' production of rising intonation was unsatisfactory. Scores of both intonation category and contour appropriateness judgments did not appear to improve beyond 7 years post-implantation. These findings suggest that CI devices can be limited in its facilitation of acquisition of rising intonation. Further studies are required to help us understand the acquisition of speech intonation both in terms of perception and production in this population.

Social interaction of pediatric cochlear implant recipients with age-matched peers.

Social interaction of pediatric cochlear implant recipients with age-matched peers.

Communication Skills in Pediatric Cochlear Implant Recipients

Detailed longitudinal studies of speech perception, speech production and language acquisition have justified a significant change in the demographics of congenitally and prelingually deaf children who receive cochlear implants. A trend toward earlier cochlear implantation has been justified by improvements in measures assessing these areas. To assess the influence of age at implantation on performance, age 5 years was used as a benchmark. Thirty-one children who received a Nucleus cochlear implant and use the SPEAK speech processing strategy and two children who received a Clarion cochlear implant and use the CIS strategy served as subjects. The subjects were divided into three groups based on age at implantation. The groups comprised children implanted before the age of 3 years (n=14), children implanted between 3 years and 3 years 11 months (n=11) and those implanted between 4 years and 5 years 3 months (n=8). The children were further divided according to whether they used oral or total communication. The earlier-implanted groups demonstrated statistically significant improvements on measures of speech perception. Improvements in speech intelligibility as a function of age at implant were seen but did not reach statistical significance. The results of the present study demonstrate that early implantation promotes the acquisition of speaking and listening skills.