Speech Intelligibility Rating Research Articles

Relationship between phoneme-level spectral acoustics and speech intelligibility in healthy speech: a systematic review

ABSTRACT This study aims to systematically review original articles investigating the link between spectral acoustic measures in healthy talkers and perceived speech intelligibility, according to the PRISMA guidelines. Twenty-two studies were retained. Eighteen papers investigated vowel acoustics, one studied glides and eight articles investigated consonants, mostly sibilants. Various spectral measures and intelligibility estimates were used. The following measures were shown to be linked to sub-lexical perceived speech intelligibility ratings: for vowels, steady-state F1 and F2 measures, the F1 range, the [i]-[U] F2 difference, F0-F1 and F1-F2 differences in [è-A] and [q-è], the vowel space area, the mean amount of formant movement, the vector length and the spectral change measure; for consonants, the centroid energy and the spectral peak in the [s]-sound, as well as the steady-state F1 offset frequency in vowels preceding [t] and [d].To conclude, as speech is highly variable even in healthy adult speakers, a better understanding of the imprecisions in healthy spontaneous speech will provide a more realistic baseline for the investigation of disordered speech. To date, no acoustic measure is able to predict speech intelligibility to a large extent. There is still extensive research to be carried out to identify relevant acoustic combinations that could account for perceived speech variations (e.g. vowel and consonant reductions) and to gather normative data from a large number of healthy speakers. To that end, speech-related terms (e.g. intelligibility, comprehensibility, severity) need to be clearly defined and methodologies described in sufficient details to allow for replication, cross-comparisons/meta-analyses and pooling of data. .

Smart speaker devices can improve speech intelligibility in adults with intellectual disability.

Successful communication is vital to quality of life. One group commonly facing speech and communication difficulties is individuals with intellectual disability (ID). A novel route to encourage clear speech is offered by mainstream smart speakers (e.g., Amazon Alexa and Google Home). Smart speakers offer four factors important for learning: reward immediacy, spaced practice, autonomy/intrinsic motivation and reduced social barriers. Yet the potential of smart speakers to improve speech intelligibility has not been explored before. To determine whether providing individuals with intellectual disabilities with smart speaker devices improved ratings of speech intelligibility for (1) phrases related to device use and (2) unrelated words via a semi-randomized controlled trial. In a semi-randomized controlled trial, an intervention group of adults with ID (N = 21) received smart speakers, while a control group (N = 22) did not. Before and after about 12 weeks, participants were recorded saying smart speaker-related phrases and unrelated words. Naïve participants then rated the intelligibility of the speech recordings. The group that received smart speakers made significantly larger intelligibility gains than the control group. Although the effect size was modest, this difference was found for both smart speaker-related phrases and unrelated words. While the mechanism of action remains to be determined, the presence of smart speakers in the home had a demonstrable impact on ratings of speech intelligibility, and could provide cost-effective inclusive support for speech and communication improvement, improving the quality of life of vulnerable populations. What this paper adds What is already known on the subject Speech intelligibility is a key obstacle for social relationships and quality of life across several vulnerable populations (children with speech difficulties, older adults with dementia, individuals with ID). Anecdotal reports suggest mainstream smart speakers (e.g., Amazon Alexa, Google Home), could improve speech intelligibility. What this paper adds to existing knowledge We used a semi-randomized controlled trial to show that using a smart speaker for about 12 weeks could improve ratings of speech intelligibility in adults with ID for both smart speaker-related phrases and unrelated words. What are the potential or actual clinical implications of this work? These initial findings suggest that smart speaker technology could be a novel, and inclusive, route to improving speech intelligibility in vulnerable populations.

Effect of age at cochlear implantation on speech and auditory performance

<p class="abstract"><strong>Background:</strong> Cochlear implants (CI) are currently widely accepted as treatment for patients with severe bilateral hearing loss. The outcomes of cochlear implantation among post lingual and crossover patients measuring surgical and functional outcomes and identifying areas which require further attention or improvement.</p><p class="abstract"><strong>Methods:</strong> This is retrospective clinical study was performed in a total of 80 children purposively screened from the patients who attended the outpatient clinic with complaints of hearing, speech or language impairment. The study group consisted those children who fit into the candidacy norms for cochlear implantation at the Department of ENT and Head-Neck Surgery, Combined Military Hospital, Dhaka from January 2017 to June 2019. Children with bilateral severe to profound sensori-neural hearing loss, age less than 5 years and prelingual deafness was included in this study. </p><p class="abstract"><strong>Results:</strong> Mean categorical auditory performance (CAP) and speech intelligibility rating (SIR) at 6 month and 12 month were statistically significant (p<0.05) compare with at 3 month. The mean post-operative CAP score was found significantly increased at 6, 12 and 24 month follow up age ≤3 years than >3 years (p<0.05). The mean post-operative SIR score was found significantly increased at 6, 12 and 24 month follow up in children age ≤3 years than >3 years (p<0.05).</p><p class="abstract"><strong>Conclusions:</strong> The majority of implanted have significantly gained auditory improvement as shown by the CAP and SIR scores in both group. Comparison between age group CAP and SIR score was significantly increased when children age <3 years than >3 years.</p>

Cochlear implantation in children with white matter lesions: Prediction of hearing outcomes by multiple regression analysis.

Brain magnetic resonance imaging (MRI) white matter lesions have been reported in some preoperative cochlear implant children. However, the role of white matter lesions in predicting the hearing outcome is yet unclear. The present study investigated the outcomes of cochlear implantation (CI) in 40 children with white matter lesions.The data from children with white matter lesions were reviewed in this retrospective study. Based on brain MRI, the patients were divided into 3 groups: mild, moderate, and severe. The children were treated with unilateral CI and monitored for a follow-up period of at least 3 years. The main outcome measures were category of auditory performance (CAP) and speech intelligibility rating (SIR). MRI white matter lesions, age at implant, gender, physical impairment, and cognitive impairment were obtained from a research database to assess the correlation with long-term CAP and SIR outcome by multiple regression analysis.The data of children with white matter lesions were reviewed (18 females and 23 males). The mean age at implantation was 31.6 months. Strikingly, all children obtained better CAP and SIR scores. The age at implantation, brain white matters lesions on MRI, and cognitive and physical disabilities were associated with CAP and SIR scores. Multiple regression established a weak correlation between the degree of white matter lesions on brain MRI and long-term CAP and SIR, while cognitive impairment strongly accounted for long-term CAP and SIR outcome.The majority of the children with brain white matter lesions obtained a satisfactory postoperative effect. The cognitive impairment before CI is a major factor, and such factor should be considered.

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.

Validity of Parent Ratings of Speech Intelligibility for Children with Cerebral Palsy

ABSTRACT Aim: To examine the relationship between subjective parent ratings of intelligibility and objectively measured intelligibility scores for children with cerebral palsy (CP) with differing levels of speech severity. Method: Fifty children (84–96 months) with CP were classified into groups based on intelligibility scores during a speech elicitation task – high intelligibility (90% or higher), mild-moderate intelligibility reduction (61–89%), and severe intelligibility reduction (60% or lower). Parent ratings of understandability (on a 7-point scale) were compared to intelligibility scores gathered from 100 naïve listeners. Results: For children with mild-moderate and severe intelligibility reduction, there was a large range of variability in parent ratings. For children with high intelligibility, ratings were consistent with intelligibility scores. There was a range of intelligibility scores within each rating, especially in the middle of the scale. Conclusions: For children with mild-moderate intelligibility deficits, parent ratings may best be used in conjunction with objective measurement of intelligibility.

Auditory Performance in Early Implanted Children with Cochleovestibular Malformation and Cochlear Nerve Deficiency.

This study aimed to report the auditory performance in children with cochleovestibular malformation (CVM)/cochlear nerve deficiency (CND) who were implanted early at the Universiti Kebangsaan Malaysia Medical Centre, using Categorical Auditory Performance (CAP)-II score and Speech Intelligibility Rating (SIR) scales, and to compare the outcome of their matched counterparts. A total of 14 children with CVM/CND with unilateral cochlear implant (CI) implanted before the age of 4 years old were matched and compared with 14 children with normal inner ear structures. Their improvement in auditory performance was evaluated twice using CAP-II score and SIR scales at 6-month intervals, with the baseline evaluation done at least 6 months after implantation. The average age of implantation was 31±8 and 33±7 months for the control group and the case (CVM/CND) group, respectively. Overall, there were no significant differences in outcome when comparing the entire cohort of case subjects and their matched control subjects in this study. However, the improvement in CAP-II scores and SIR scales among the case subjects in between the first and second evaluations was statistically significant (p=0.040 and p=0.034, respectively). With longer duration of CI usage, children with CVM/CND showed significant speech perception outcome evident by their SIR scales (p=0.011). Children with radiographically malformed inner ear structures who were implanted before the age of 4 years have comparable performance to their matched counterparts, evident by their similar improvement of CAP-II scores and SIR scales over time. Hence, this group of children benefited from cochlear implantation.

Validation and inter-rater reliability testing of the Arabic version of speech intelligibility rating among children with cochlear implant.

Objectives:To validate and assess the reliability of the new version of an Arabic speech intelligibility rating among different raters.Methods:This cross-sectional analysis was carried out between December 2018 and January 2019. Thirty cochlear-implant (CI) children (study group) and 30 subjects (control group) were enrolled. Study candidates’ speech skills were evaluated using the translated Arabic SIR by parents and original SIR by professions such as speech-language pathologists (SLPs). Inter-rater agreement, test–retest reliability, pre- and post-intervention score (responsiveness test), patient versus control score comparison (discriminant validity), and cross-validation of Arabic SIR have all been assessed.Results:There was a good sense of agreement between the post-operative SIR parents’ assessments and the professional SLPs’ assessments (r=0.920, p<0.001). The mean of study subjects pre- and post-implantation score of Arabic SIR showed a statistically significant difference (p<0.001).Conclusion:The Arabic SIR demonstrated excellent reliability with strong consistency. It showed its clinical ability in distinguishing healthy subjects from patients along with follow up of speech development skills over time. The Arabic SIR can be used by parents to evaluate post-CI progress of their children.

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.

Factors affecting outcome of cochlear implant: an observational study

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Aim and objectives of the study was to evaluate various factors affecting outcome in cochlear implant surgery.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A hospital based retrospective observational study in which 51 patients who underwent cochlear implant surgery from July 2017 to January 2019 were evaluated at Dr. Babasaheb Ambedkar Memorial Hospital, Byculla, Mumbai using 3 parameters i.e. Revised CAP score (CAP), meaningful auditory integration scale (MAIS), speech intelligibility rating (SIR) at various intervals postoperatively and outcome was evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;It was found that the postoperative mean scores in all age groups were comparable but not significant at 3, 6 and 9 months interval while the difference was statistically significant at 12 and 24 months interval post implantation with less than 2 years age group performing better than other age groups patients with less than 2 years duration of auditory deprivation, the mean scores were found to be statistically significant at 12 and 24 months implantation Relationship to common causes such as prenatal infections, low birth weight, prolonged labour, hyperbilirubinemia, meningitis and consanguineous marriage were considered but not significant. No significant difference was observed in parent’s education level, urban-rural population to the outcome of cochlear implantation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Two most important factors that affect the outcome cochlear implantation are the age at implantation and the duration of auditory deprivation. Other factors are important but not significant and do not affect the outcome significantly.&lt;/p&gt;

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.

The French Cochlear Implant Registry (EPIIC): Perception and language results in infants with cochlear implantation under the age of 24 months

ObjectiveMulti-centre study of the National French Registry (EPIIC) of patients with cochlear implants, focusing on infants who were operated-on under the age of 24 months between 2012 and 2016. Patients and methodsA total of 615 profoundly deaf infants, who received cochlear implants (CIs) before their second birthday, were included in the registry by different CI centers. Epidemiological, surgical, speech therapy and school, follow-up data were included in the registry, 12, 24, 36 and 48 months thereafter. The following parameters were studied: type of implantation (uni- or bilateral), complications, cause of deafness, category of auditory perception (CAP), Open-set word recognition score (OSW), speech intelligibility rating, lexical comprehension with EVIP (Peabody), communication mode and type of schooling. Bilateral simultaneous CI (BiCI) and unilateral CI (UniCI) groups were compared. ResultsThere were 744 implantations. The explantation-reimplantation rate, within the four-year follow-up, was just 3.6%. Mean implantation age was 16.0 months, and similar in the two groups (BiCI/UniCI). A total of 51% of children had their first implant between 12 and 18 months, and 15% before 12 months. Implantation was unilateral in 52% of cases. Fifty-six percent of the bilateral procedures were sequential, with a mean delay of 16.8 months for the second implantation. The cause of deafness was unknown in 52% of cases. Of the 48% (297/615) of attributed cases, 32% had clear genetic causes. The remaining deafness was due to cytomegalovirus (CMV, 8%), inner-ear malformation (5%) and meningitis (3%). The main complications were from infections (47%) and internal device failure (25%). Four years post-operation, 84% of the UniCI and 75% of BiCl groups had a CAP≥5, and 83% of UniCl and 100% BiCI had OSW≥80%. Furthermore 74% of UniCI and 77% of BiCI communicated orally and 85% of UniCI and 90% of BiCI integrated into mainstream schooling. ConclusionThe French Registry of cochlear implants (EPIIC) is the only such national registry in the world. Our analysis illustrates the immediate benefits of, either single or double, cochlear implantation for language, perception skills and schooling.

A Study of Outcome of Pediatric Cochlear Implantation in Patients with Cochleovestibular Nerve Deficiency.

A cochleovestibular nerve deficiency (CVND) could compromise stimulation of nerve by electrical pulses delivered from a cochlear implant, thereby hindering activity along auditory pathway. The evaluation of children with congenital hearing loss with a high-resolution magnetic resonance imaging is presently the investigative modality of choice to diagnose CVND. The aim of this study was to determine the outcomes in pediatric cochlear implant recipients with a diagnosis of CVND. The objectives included (1) to study the prevalence of CVND among children with prelingual congenital severe to profound hearing loss; (2) to assess post cochlear implantation (CI) outcomes in children with CVND using categories of auditory performance (CAP), speech intelligibility rating (SIR), and cortical auditory evoked potentials (CAEPs); and (3) to propose a management protocol for these children. All CI procedures performed during the study period in children 5 years or younger were included in study. All patients who were older than 5 years or had syndromic associations, multiple disabilities, second side or revision CI were excluded from the study. Children with unilateral cochleovestibular nerve aplasia and all other cases of CVND (type IIa and IIb) were advised to undergo CI on side with more radiologically robust nerve and/or cochlea anatomy. Children with bilateral CVND were included in group A, and age-matched cochlear implant candidates with normal cochleovestibular nerve anatomy were included in group B for statistical comparison of outcomes. In group A, post CI CAP and SIR, CAEP amplitude and latency at 12 months showed statistically significant difference (p<0.05) compared with preoperative values. However, mean score of CAEP latency and amplitude and SIR score was worse for group A compared with group B at 12 months, which was statistically significant (p<0.05). This study supports the fact that CI is a viable option to be offered in children with CVND (type IIa and IIb) for the development of auditory perception and speech.

Outcomes of Hearing Aid and Cochlear Implantation in Case of Congenital Non-Syndromic Bilateral Severe to Profound Sensorineural Hearing Loss: An Observational Study.

This study was done to measure the outcomes of hearing aid (HA) and cochlear implantation (CI) in case of congenital non syndromic severe to profound sensorineural hearing loss (SNHL) by using aided audiometry (AA), categories of auditory perception (CAP) score and speech intelligibility rating (SIR) scale. The objectives were to find out the effective management options available for bilateral severe to profound SNHL, to study the impact of age of CI on language development and to study the outcome of HA and CI. Patients with congenital severe to profound SNHL were included in the study. Initially the case history of the participants was taken then they underwent audiological tests to confirm hearing loss. To assess the outcomes of HA and CI, they were initially fitted with high gain digital behind the ear HA, then underwent auditory verbal therapy for twelve months, after that AA, CAP and SIR test done to measure the outcomes of HA and similar hierarchy followed for CI. The results showed that with HA, the benefit is very limited whereas with CI the benefit is significant. The average SIR score of HA and CI are 1 and 3.16 and average CAP score are 0.83 and 7.8 respectively. The study shows that the CI is one of the most effective management options available for severe to profound SNHL and found that early intervention followed by early detection of hearing loss helps in achieving better speech and language skills.

Pediatric Cochlear Implantation: Who is a Candidate in 2020?

Pediatric Cochlear Implantation: Who is a Candidate in 2020?

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.

Cochlear implantation in prelingually deaf children with white matter lesions.

White matter lesions (WMLs) are the most common central nervous system changes observed during cochlear implant evaluation. However, its clinical significance in cochlear implantation (CI) remains unclear. The purpose of this study is to explore the effects of WMLs on hearing and speech rehabilitation of prelingually deaf children after CI. The data of forty-five children with WMLs who received CI from 2011 to 2014 were retrospectively reviewed. All patients underwent magnetic resonance imaging examination preoperatively. The categories of auditory performance (CAP) and speech intelligibility rating (SIR) scales were used to evaluate changes in the auditory and speech abilities of the patients, and the Fazekas scale was adopted to assess the extent of WMLs. The degree of WMLs was divided into four grades (none, mild, moderate, severe). We assessed hearing and speech abilities at the following time points: 6, 12, 24, 36, 48 and 60-months post-operation. No significant differences in CAP scores were observed between WMLs groups and the control group at 12months post-CI (p = 0.099), but marked between-group differences were found at 6, 24, 48- and 60-months post-CI. (p < 0.05). Similarly, no significant differences in the SIR scores were observed at 6months post-CI (p = 0.087), but marked between-group differences were found at 12, 24, 48- and 60- months post-CI. (p < 0.05). Analysis of stratified group results revealed improvements in hearing and speech development for all the subgroups, including the severe WMLs subgroup following CI. However, hearing and speech ability of the severe WMLs subgroup was much slower than that of other groups. The auditory and speech abilities of prelingually deaf children with WMLs and those without WMLs can improve after CI. Therefore, WMLs should not be considered a contraindication for CI. However, the decision to perform CI in such patients needs a comprehensive evaluation because the post-surgery effects on children with severe WMLs are not ideal.

Influence of family environment on the outcomes of cochlear implantation in pediatric recipients

Objectives:To determine whether family environment and demographic factors such as family income and education produce any significant difference in postoperative performance of cochlear implant (CI)patients.Methods:In this study, 49 participants who received cochlear implant devices at King Abdullah Ear Specialist Center, Riyadh, Saudi Arabia before the age 5 years were included. Data were collected between July 2019 and August 2019. Postoperative performance was assessed by speech intelligibility rating (SIR) and categories of auditory performance (CAP) scales. Family environment was assessed with family environment scale (FES) survey. Data of demography, average income, and maternal and paternal education were obtained through review of patient’s medical files. The data obtained were analyzed using Statistical Package for Social Sciences for Mac, version 23 (IBM Corp, Armonk, NY, USA).Results:A significant difference between the organization categories of FES (p<0.05) was observed in terms of postoperative CAP scores, while a significant effect of the expressiveness category on both postoperative CAP and SIR scores (p<0.05) was observed. The scores on both CAP and SIR scales were significantly affected by maternal education, and the scores on SIR scale were positively correlated with paternal education.Conclusion:This study suggests that post-procedural performance of auditory perception and speech intelligibility in CI patients is significantly related to the family environment as well as the education levels of the parents.

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.

Influence of family environment on the development of speech and language in pre-lingually deaf children after cochlear implantation.

To investigate the influence of family environment on the development of speech and language in pre-school children after cochlear implantation. A total of 88 pre-lingually deaf children, aged 2-5years, who received cochlear implantation, were included in this study. All families completed a self-report family environment questionnaire (FES). The deaf children's linguistic progress was assessed by Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) at 0, 3, 6 and 12months after implantation. The family environment was the significant factor associated with CAP and SIR at 6months post-implantation. The children in families with higher levels of Cohesion, Intellectual-Cultural Orientation and the ability to express emotion effectively had better auditory and speech abilities, while children in families with low intimacy and high incompatibility exhibited a delay in the development of auditory speech (P<.05). The development of speech and language in pre-lingually deaf children after cochlear implantation can be influenced by family environment and parents' roles.