Prelingual Children Research Articles

Investigating the Relationship between Non-verbal Intelligence and Adaptive Behavior in Hearing Impaired Children

The present study intended to find out the relationship between nonverbal intelligence and adaptive behaviors in children with pre-lingual and post-lingual hearing loss. A total of 200 hearing impaired children were purposively selected from Government Special Education institute in district Khanewal who aged between 6 to 11 years. The Vineland Adaptive Behavior Scale, and Raven’s Colored Progressive Matrices were used to collect the data from participating hearing impaired children. Results showed that intelligence has significant positive relationship with daily living and motor skills, and significant negative relationship with communication and socialization skills. The independent samples t test revealed a significant difference in prelingual and post lingual children in intelligence levels with little effect size. Further, the prelingual children showed more motor behavior as compared to children in post lingual group. It is important to gather a wide range of data on adaptive behavior and intelligence, including information on performance in various contexts, from various sources, and using varied techniques.

The Effect of Universal Newborn Hearing Screening on Spoken Language after Cochlear Implantation.

The universal newborn hearing screening (UNHS) was fully implemented across New Zealand by 2010 to improve outcomes for children with prelingual deafness. A previous audit undertaken by our center, the Southern Cochlear Implant Programme (SCIP), demonstrated that UNHS has significantly reduced the time to referral and surgery for cochlear implants in these children. This study aims to evaluate the relationship between earlier implantation and language development, the time taken to achieve age-appropriate language, and the effect of socioeconomic status on language skills. This is a retrospective cohort study comparing prelingual children with severe to profound bilateral hearing loss who underwent cochlear implantation in SCIP before and after the introduction of the UNHS. The language outcomes were assessed using the Preschool Language Scale and/or the Peabody Picture Vocabulary Test. For the purpose of our study, the standard scores of these tests were expressed as global language scores (GLS). GLSs between 85 and 115 are considered within normal range for age. The socioeconomic status was categorized based on the New Zealand Index of Deprivation (NZDep). Children in the post-UNHS group (46/95 children) were referred to SCIP and received CI at a significantly earlier age (mean = 7 vs 20 mo, p = 8.95E-10, and mean = 13 vs. 24.7 mo, p = 1.43E-07). At 2 years postimplantation, the GLS was significantly higher in the post-UNHS group (mean scores = 93.3 vs. 79.1, p = 0.0213). The scores remained statistically higher in the post-UNHS group when assessed at 3 and 4 years postimplantation. At 2, 3, and 4 years postimplantation, there is a significant linear decrease in GLS with increasing age at cochlear implantation. We found no correlation between NZDep and GLS. Children identified through UNHS have the advantage of earlier diagnosis, earlier hearing intervention, and longer duration with the implants, and they can achieve age-appropriate spoken language after 2 years of implantation.

A systematic review of the effect of cochlear implantation on cognition in pre-lingual children

Abstract Purpose: The purpose of the current study was to summarize existing literature on cognitive outcomes in children with cochlear implant (CI) using behavioral and electrophysiological methods. Method: The study used a literature search on PubMed, Google Scholar, and Science Direct databases using appropriate keywords. After a thorough full-length review, articles were selected based on the study objectives. The selected articles underwent quality analysis using a critical appraisal skills programme (CASP) questionnaire, and 34 articles were finalized for review. Result: The review gave an insight into cognitive outcomes in children with CI. In all the behavioral nonverbal cognitive tests, children with CI showed cognitive development similar to that of normal-hearing children. Cognitive scores showed a modality-specific result. Tasks requiring visual modality such as visual memory were not affected in children with CI even before the implantation. Whereas tasks using the auditory modality showed poorer scores in implanted children. Over the years, implanted children were on par with normal-hearing children in most of the cognitive domains except higher domains such as reasoning. However, in electrophysiological tests, varied results were found. Conclusion: Cochlear implants provide not only a long-term sensory benefit but also help in improving the overall cognition of children. The study also focuses on the importance of early implantation and suitable rehabilitation for appropriate cognitive development.

Efficacy of auditory verbal therapy in children with cochlear implantation based on auditory performance – A systematic review

This systematic review focuses on the efficacy of auditory verbal therapy (AVT) in children with cochlear implants based on their auditory performance. The results presented are based on research findings from 2010 to 2021. The systematic review was designed based on the Popular Reporting Systems for the Systematic Review and Analysis of Meta-Analysts (PRISMA), the 2020 revised version, and the Critical Evidence for Clinical Evidence (CATE) checklist. Specific keywords were chosen based on the formulated research question and searched on the following search engines: Google Scholar, Microsoft Academic, PubMed, Semantic Scholar, Cochrane, Science Direct, and BASE. All the searched articles were analysed based on specific exclusion criteria. The results revealed an important progression based on the auditory performance among children with cochlear implantation who received habilitation. The studies highlight that younger the age at implantation better the auditory performance and this may be necessary to allow at least relatively normal organization of auditory pathways in pre-lingual children with hearing impairment. Therefore, regular revitalization of aural–verbal rehabilitation and speech and language therapy is essential for younger children with hearing impairment to achieve the highest level of hearing function. This systematic review highlights importance of assessment of the auditory performance to be considered in the test battery while evaluating children with CI before and after habilitation along with AVT.

Application Effect of Unilateral Cochlear Implantation Combined with Contralateral Hearing Aids on the Hearing and Speech Rehabilitation in Prelingual Deafness Children

Objective. The purpose of the study was to investigate the application effect of unilateral cochlear implantation combined with contralateral hearing aids on the hearing and speech rehabilitation in prelingual deafness children. Methods. In this study, a total of 78 children with severe or extremely severe sensorineural prelingual deafness admitted to our hospital from January 2015 to December 2017 were selected and divided into control group (n=39) and experimental group (n=39), according to the random number table. Among them, the children patients in the control group received dominant training after unilateral cochlear implantation, while the children patients in the experimental group received cochlear implantation combined with contralateral hearing aids; after that, the hearing and speech rehabilitation outcomes of the prelingual deafness children in both groups were compared and analyzed. Results. There were no statistically significant differences in the auditory thresholds of the children patients undergoing cochlear implantation between the two groups, while the auditory thresholds of contralateral ears of the children patients in the experimental group were significantly lower than those in the control group. The recognition rates of the initials, finals, tones and disyllables of the children patients in the experimental group were significantly higher than those in the control group, and the CPA and SIR scores of the children patients in the experimental group were significantly higher than those in the control group, with statistical significance (P < 0.05). Conclusions. Unilateral cochlear implantation combined with contralateral hearing aids can promote the hearing and speech rehabilitation in prelingual deafness children, with better clinical effect than the single unilateral cochlear implantation, and cochlear implantation have no interference in the work of contralateral hearing aids; therefore, this joint treatment method is worthy of wide application and promotion.

Outcomes of Acoustic and Linguistic Performances Following Cochlear Implantation in Large Vestibular Aqueduct Syndrome (LVAS).

This study aims to collate the outcomes in acoustic and linguistic performances after cochlear implantation in LVAS. In a hospital-based prospective interventional study, seven prelingual children with bilateral profound sensorineural hearing loss(SNHL) with LVAS were recruited. They underwent unilateral cochlear implantation between December 2013 and December 2015 in the Department of Otorhinolaryngology and Head Neck Surgery at a tertiary care center. Outcomes of auditory and speech performances were assessed in the form of revised categories of auditory perception (CAP), infant toddler meaningful auditory integration scale (IT-MAIS) and speech intelligibility rating (SIR) scores preoperatively, at one and two years follow up. The mean age of implantation was 4years. The median revised CAP, IT-MAIS, and SIR scores after one and two years of follow-up were 6, 27, 3, and 11, 36, 5 respectively. The mean follow-up duration was 21.3months. Pre op median revised CAP, IT-MAIS, and SIR scores of 0, 1, 1 showed improvement to 11, 36, 5 at two years follow up which was statistically significant. Hence, we conclude that good functional outcomes post-operatively advocate the significance of cochlear implantation in LVAS.

The effect of age at time of cochlear implantation on the pragmatic development of the prelingual hearing impaired children

BackgroundPragmatics is the social use of language that draws on understanding human interactions in specific contexts and requires engagement with a communicative partner or partners. The hearing-impaired children are known to have a pragmatic language delay as hearing impairment deprived of exposure to natural communication interactions, in addition to the language delay they have. Since the age of implantation has emerged as an important predictor of language, hearing, and speech in children who use cochlear implants (CI), question aroused about the benefits of early cochlear implantation on pragmatic language development in those children. Thus, this study aims to compare the pragmatic language development of the prelingual hearing impaired children who cochlear implanted before the age of 3 years and those who cochlear implanted after the age of 3 years.ResultsThe two study groups showed no significant differences regard their scores in the Egyptian Arabic Pragmatic Language Test (EAPLT). The two studied groups had pragmatic language scores below their 5th percentile. Among the studied groups, the scores of the EAPLT were positively correlated to the age of the children, the children’s language abilities, and the duration of the received language rehabilitation, with no significant correlation to the age of implantation.ConclusionsThe age of implantation has no impact on pragmatic language development in children with CI. The prelingual children with CI are susceptible to delays in the pragmatic language development that is primarily related to the age of those children and their language abilities, besides their experience in social interactions. These results should be considered in their rehabilitative plan and advocate the importance of early incorporation of pragmatic behaviors into their intervention programs.

Evaluation of working memory in relation to cochlear implant consonant speech discrimination

BackgroundSpeech perception in cochlear implants (CI) is affected by frequency resolution, exposure time, and working memory. Frequency discrimination is especially difficult in CI. Working memory is important for speech and language development and is expected to contribute to the vast variability in CI speech reception and expression outcome. The aim of this study is to evaluate CI patients’ consonants discrimination that varies in voicing, manner, and place of articulation imparting differences in pitch, time, and intensity, and also to evaluate working memory status and its possible effect on consonant discrimination.ResultsFifty-five CI patients were included in this study. Their aided thresholds were less than 40 dBHL. Consonant speech discrimination was assessed using Arabic consonant discrimination words. Working memory was assessed using Test of Memory and Learning-2 (TOMAL-2). Subjects were divided according to the onset of hearing loss into prelingual children and postlingual adults and teenagers. Consonant classes studied were fricatives, stops, nasals, and laterals. Performance on the high frequency CVC words was 64.23% ± 17.41 for prelinguals and 61.70% ± 14.47 for postlinguals. These scores were significantly lower than scores on phonetically balanced word list (PBWL) of 79.94% ± 12.69 for prelinguals and 80.80% ± 11.36 for postlinguals. The lowest scores were for the fricatives. Working memory scores were strongly and positively correlated with speech discrimination scores.ConclusionsConsonant discrimination using high frequency weighted words can provide a realistic tool for assessment of CI speech perception. Working memory skills showed a strong positive relationship with speech discrimination abilities in CI.

Hearing-impaired Children and Adults in Need of Cochlear Implant- A Hospital Based Cross-sectional Study

Introduction: Hearing is essential to learn language and speech and to develop cognitive skills. According to World Health Organisation (WHO), world-wide approximately 350 million people have hearing disorder. The performance of some moderately severe hearing-impaired adults and children using hearing aids is poorer than that of even profoundly hearing-impaired individuals using cochlear implants with advanced speech processing strategies. Aim: To find out the appropriate candidates in need of cochlear implantation in Prayagraj district of Uttar Pradesh, India. Materials and Methods: This cross-sectional study was conducted on hearing impaired patients attending Ear Nose Throat (ENT) Out Patient Department (OPD) of tertiary health care center in Prayagraj Uttar Pradesh from August 2011 to July 2012. The study population consisted of 95 patients categorised into four groups (pre-lingual children and adults, post-lingual children and adults) who presented with the chief complaints of impaired hearing and delayed speech. A detailed history, clinical and other relevant systemic examination and investigations were done. Patients were subjected to free field audiometry, pure tone audiometry and Brainstem-Evoked Response Audiometry (BERA) for assessment of hearing threshold level. Patients used hearing aid for six months and after hearing aid use, their hearing threshold and speech discrimination scores were estimated. Patients, whose aided score on open-set sentence test was less than 50%, were selected as candidate for cochlear implants, as they were not significantly benefited by hearing aids. Results: Out of the 95 cases, 48 were found to be suitable for cochlear implantation, which formed 50.5% of the study group. Pre-lingual hearing impaired adults had the highest percentage i.e., 86.7%, fulfilling the criteria for cochlear implantation followed by pre-lingual children, in whom 46.7% fell in this category. A 26.7% of postlingual children and 20% of postlingual adults were found suitable for cochlear implantation. Conclusion: The pre-lingual hearing impaired children and adults are more in need for cochlear implantation than the postlingual hearing-impaired children and adults. Approximately, 134,501 cases were estimated to be, in need of cochlear implantation in Prayagraj district based on the census estimate of 2011.

Correlation of cochlear nerve cross-sectional area and auditory performance after cochlear implantation in prelingual children with bilateral profound hearing loss

ObjectiveTo assess whether cochlear nerve (CN) cross-sectional area as measured with parasagittal magnetic resonance imaging (MRI) in prelingual pediatric deaf patients correlates with auditory performance after cochlear implantation. Study designProspective Cohort study. MethodsThirty-two prelingual children with bilateral profound sensorineural hearing loss (SNHL) who received unilateral cochlear implant were included in this study. Diameters of CN at Internal auditory canal (IAC) fundus and mid-point of IAC were retrospectively measured on parasagittal images of FIESTA (Fast Imaging Employing Steady-state Acquisition) sequence MRI by two independent observers. Cross-sectional areas [π (Height/2) (Width/2)] were then correlated with post-operative CAPS (Categories of Auditory Performance) and IT-MAIS (Infant-Toddler Meaningful Auditory Integration Scale) scores regularly assessed at 3 monthly intervals post device activation. ResultsThe cochlear nerve was identified in all the 32 patients. Mean cross-sectional areas (CSA) of cochlear nerve were 0.71 ± 0.16 mm2 at IAC fundus and 0.73 ± 0.18 mm2 at mid-point of IAC. The correlation value between CSA at mid-point of IAC and CAPS score at 6 months was 0.271 (p-value- 0.140) and correlation value between CSA at mid-point of IAC and IT-MAIS score at 6 months was 0.282 (p-value- 0.124) which were statistically not significant. ConclusionThere was no significant correlation between the cross-sectional areas of the cochlear nerve on MRI and postoperative auditory scores as measured by CAPS and IT-MAIS scores at six months from the device activation. Hence, we conclude that above an adequate diameter, which can affect the minimum required neurons, the changes in the diameter do not have significant bearing on auditory outcomes after cochlear implantation.

Trajectory of auditory and language development in the early stages of pre-lingual children post cochlear implantation: A longitudinal follow up study

ObjectivesThe aim of this longitudinal follow-up study was to explore the trajectories of early auditory and language development in Mandarin speaking children younger than 3 years of age following switch-on of their cochlear implants (CIs). MethodsEarly auditory and language development was measured longitudinally using the Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS), which is a commonly used tool for assessing early prelingual auditory development (EPLAD) in children, and the subtest (Words and Gestures, W&G) of the simplified short form version of the Mandarin Communicative Development Inventory (SSF-MCDI) to assess receptive and expressive vocabulary growths of children in 24 pediatric cochlea implant recipients at baseline, 3, 6, and 12 months following switch-on. Age at switch-on ranged from 1 to 3 years of age. Participants were divided into two groups based on age at switch-on. The IT-MAIS and SSF-MCDI (W&G) scores were analyzed with comparison to normal children, unaided hearing-impaired children, and CI children. ResultsSignificant improvements in IT-MAIS and SSF-MCDI (W&G) scores from baseline to 12 months were seen after switch-on in both CI groups and were comparable to the normal hearing children in the first year of age. The IT-MAIS scores of CI children in both groups at 12 months after switch-on surpassed the average level of unaided peers with profound hearing loss and were similar to the average level of unaided peers with mild hearing loss. SSF-MCDI (W&G) scores in word comprehension and expression were significantly different between groups at some intervals. ConclusionsChildren younger than 3 years of age with cochlear implants have similar trajectories in early auditory and language developments to normally hearing children. Moreover, early implantation is an important factor for the early auditory development when comparing EPLAD results between CI children and unaided peers with different hearing loss. Finally, it is noteworthy that CI children master the skill of word comprehension before the skill of word expression, and that word comprehension may be the basis of word expression.

Efficacy of using NRT thresholds in cochlear implants fitting, in prelingual pediatric patients

ObjectiveTo evaluate the efficacy of using neural response telemetry (NRT) thresholds in predicting behavioural thresholds during programming of cochlear implant in prelingual children. MethodProspective study of 28 cochlear implants implanted with Nucleus 24 cochlear implant. We recorded NRT-thresholds on electrode numbers 1, 6, 11, 16 and 22 of the electrode array in each patient, the neural response thresholds were correlated with the behavioural map after six months of programming the device. ResultsThe mean neural response telemetry level was significantly higher than the mean threshold level (T-level) but lower than the comfortable level (C-level) in all the electrodes tested. NRT levels could statistically significantly predict T behavioural levels and comfortable behavioural levels, p < 0.01. There was a strong positive correlation between comfortable thresholds and neural response telemetry level measurements and behavioural threshold level and neural response telemetry threshold measurements. ConclusionThere is a useful role for neural response telemetry values in predicting the behavioural threshold and comfortable values in prelingual children. Combining the NRT values with behavioural observations can improve the programming of cochlear implants.

Value of auditory perception of alphabet letters test (Arabic standardized version) in evaluation of Arabic speaking CI children

Background: Cochlear implant (CI) is a hearing device that helps hearing impaired children who did not benefit from conventional hearing aids to restore a satisfactory level of auditory sensation. The proper verification of their auditory speech and language performance helps gain the best outcomes. Speech perception tests are basic assessment tools. They are considered as supra-threshold tests that use different speech materials that are reliable for hearing impaired children.Objectives: The aim of this study is to assess the correlation between the different speech perception tests and auditory skills, language acquisition and speech parameters for cases with CI children in Zagazig University Hospitals. This will help develop an appropriate battery for verification of CI children.Design: This study was applied on 21 children with CI who had implanted before the data collection period. For all participants aided thresholds, APAL, WIPI and PBKG tests were done in the audio-vestibular medicine unit for assessment of audiological outcomes. Assessment of auditory skills, language acquisition and speech parameters were done in the Phoniatric Unit. The results were collected and statistically analyzed.Results: There was a strong positive correlation between APAL and TLA, auditory skills and intelligibility of speech, which was superior to other speech perception tests.Conclusion: APAL can be used as a reliable speech discrimination test that can anticipate the progress in different skills of pre-lingual CI children.

Understanding acoustic-phonetic environments of prelingual children with cochlear implants: Challenges, tools, and insights

Variability in auditory and linguistic environments experienced by prelingual children with cochlear implants (CIs) potentially helps explain variation in their language outcomes. Here, results are presented from several studies from our lab investigating early acoustic-phonetic environments of children with CIs. One collaborative study conducted over 10 years investigated individual differences in acoustic-phonetic quality of maternal speech as predictors of language outcomes in children with CIs. Results showed that properties of maternal speech recorded in the lab—as indexed in part by measures derived from vowel formants and fundamental frequency—significantly predicted infants’ language outcomes and growth on multiple standardized assessments two years after cochlear implantation. Other work has examined the usefulness of a widely adopted commercial automatic speech processing technology—the Language ENvironment Analysis (LENA) system—for investigating individual differences in auditory environments. Results from our study suggested considerable variability across samples in LENA’s accuracy at identifying adult speech, limiting LENA’s value for investigating individual differences in acoustic-phonetic input to children with CIs. Finally, an update is provided on current work using combined signal processing and hand-coding approaches aimed at investigating variability in acoustic input to children with CIs in their home environments. [Work supported by NIH grant R01DC008581.]

Cortical auditory plasticity in children with Cochlear implants

Objectives:The purpose of the current study was to investigate plasticity of auditory system following cochlear implants (CI) in prelingually severe to profound hearing-impaired chil¬dren using cortical auditory evoked potentials (CAEPs) and correlate it with auditory perception performance.Methods:A total of 28 (15 boys, 13 girls) children with profound hearing loss, who underwent CI at Ahvaz Jundishapur University of Medical Sciences, Iran, were included in this study. Their mean age at the time of implantation was 21.3 months. All children were evaluated before implantation and 3 months after implantation using the CAEPs and categorical auditory performance (CAP). For CAEP measurement, the stimuli on the HEARLab system (/m/, /g/, and /t/) were extracted from running speech and presented at 65 dB SPL.Results:The mean CAP and P1 amplitude values were increased from pre-CI condition to 3-month post-CI condition (Paired t-test, p 0.05).Conclusion:The present study indicated that early cochlear implantation, will improve cortical auditory plasticity and auditory performance ability in pre-lingual hearing-impaired children.

Speech language development after cochlear implants in prelingual children according to the age of implantation

Speech language development after cochlear implants in prelingual children according to the age of implantation

Site of prelingual cochlear stimulation and its effect on electrically evoked compound action potentials and refractory using the Nucleus 24 standard

Objective:To investigate the correlation between the site of prelingual cochlear stimulation and its effect on electrically evoked compound action potentials. Method:Recordings of auditory nerve responses were conducted in 32 prelingual subjects to demonstrate the feasibility of ECAP recordings using the nerve response telemetry(NRT) feature of the Nucleus CI24R(CA) system software. These recordings were then analyzed based on the site of cochlear stimulation defined as basal, middle and apical to determine if the amplitude, threshold and slope of the amplitude growth function and the refractory time differs depending on the region of stimulation. Result:Findings of our prelingual children showed significant differences in the ECAP recordings depending on the stimulation site. Comparing the apical with the basal region, on average higher amplitudes, lower thresholds and steeper slopes of the amplitude growth function hadbeen observed. The refractory time showed an overall dependence on cochlear region; however post-hoc tests showed no significant effect between individual regions. Conclusion:Obtaining ECAP recordings is also possible in the most apical region of the cochlea. However, differences can be observed depending on the region of the cochlea stimulated. Specifically, significant higher ECAP amplitude, lower thresholds and steeper amplitude growth function slopes have been observed in the apical region. These differences between prelingual children and adults could be explained by the location of the stimulating electrode with respect to the neural tissue in the cochlea, a higher density, or an increased neural survival rate of neural tissue in the apex.

Audio-visual speech perception in noise: Implanted children and young adults versus normal hearing peers

ObjectiveThe purpose of the current study was to evaluate auditory, visual and audiovisual speech perception abilities among two groups of cochlear implant (CI) users: prelingual children and long-term young adults, as compared to their normal hearing (NH) peers. MethodsProspective cohort study that included 50 participants, divided into two groups of CI (10 children and 10 adults), and two groups of normal hearing peers (15 participants each). Speech stimuli included monosyllabic meaningful and nonsense words in a signal to noise ratio of 0 dB. Speech stimuli were introduced via auditory, visual and audiovisual modalities. Results(1) CI children and adults show lower speech perception accuracy with background noise in audiovisual and auditory modalities, as compared to NH peers, but significantly higher visual speech perception scores. (2) CI children are superior to CI adults in speech perception in noise via auditory modality, but inferior in the visual one. Both CI children and CI adults had similar audiovisual integration. ConclusionsThe findings of the current study show that in spite of the fact that the CI children were implanted bilaterally, at a very young age, and using advanced technology, they still have difficulties in perceiving speech in adverse listening conditions even when adding the visual modality. This suggests that adding audiovisual training might be beneficial for this group by improving their audiovisual integration in difficult listening situations.

Indices for the determination of the degree of communication skills improvement in prelingual children with cochlear implantation

Abstract Monitoring and documenting the progress in communication skills of cochlear implanted (CI) children is important for intervention planning, conduction of evidence-based studies, and reporting parents about their children’s progress. The aim of the present study was to provide reliable indices that may be used to monitor a child’s communication skills progress after CI and to grade his or her performance. The study was carried out on 53 prelingual CI children (28 boys and 25 girls). Their ages ranged from 2.5 to 6 years. They were all of average intelligence and showed no associated disorders. They were all enrolled for verbal auditory training at the Unit of Phoniatrics. The CI children were evaluated postoperatively using the quasi-objective description of communicative ability, following scaling by transformation from the lower stages to the higher stages in communicative performance. This entailed the determination of the levels for auditory performance, receptive and expressive language, speech intelligibility, mode of communication, approximate language age, vocabulary size, and speech sounds perception. After 1 year of implantation, the children were re-evaluated and the levels achieved in each item and on the therapy program were recorded. The subjective impression of improvement was marked as poor, fair, or good, which was determined by the phoniatrician, therapist, and the parents for each child. Expressive language development and speech intelligibility in the presence of marked speech perception are significant indicators for communication skills progress. The indices provided for various degrees of improvement are helpful to conduct evidence-based research, especially in the absence of reliable formal testing.

Mansoura University habilitation outcome of prelingual cochlear-implanted children: 5 years of experience

Abstract The aim of this study was to explore the effects of different preimplantation and postimplantation factors on the postimplant outcome of prelingual cochlear-implanted (CI) children as regards their auditory and language development. This retrospective study included a sample of 33 prelingual CI children who were presented to the Phoniatric Unit, Mansoura University Hospitals, Mansoura, Egypt, and were implanted during the last 5 years starting from August 2009 to August 2014. All children received structured auditory and language therapy sessions after CI twice weekly. They were subjected to the protocol of assessment of a delayed language development (before and after language therapy sessions) using subjective and quasiobjective measures of evaluation including improvement quotient assessment, language assessment, and assessment of auditory abilities including detection, discrimination, identification, and comprehension. The results of the study proved that the better habilitation outcomes after CI children are correlated with young age at CI surgery, preoperative improvement quotient, language therapy before and after implantation, and regularity of hearing aids usage before surgery. Early CI of the prelingual children is recommended to minimize initial language delays and to promote the development of age-appropriate communication skills.