A Prospective Longitudinal Study of U.S. Children Unable to Achieve Open-Set Speech Recognition 5 Years After Cochlear Implantation

Barnard, Jennifer M.; Fisher, Laurel M.; Johnson, Karen C.; Eisenberg, Laurie S.; Wang, Nae Yuh; Quittner, Alexandra L.; Carson, Christine M.; Niparko, John K.

doi:10.1097/mao.0000000000000723

Cited by 32 publications

(26 citation statements)

References 51 publications

(47 reference statements)

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“…(39,40) For example, the 1-year data in the present study indicate lower scores on the IT-MAIS/MAIS and ESP than the 1-year post CI mean scores for 42 pairs (CI and normally hearing) of children assessed in the national Childhood Development after Cochlear Implantation (CDaCI) study. (41) Young(32) reported that in some cases of CI in cochlear nerve deficiency, development of adequate responses may take several years.…”

Section: Discussionmentioning

confidence: 70%

Initial Results of a Safety and Feasibility Study of Auditory Brainstem Implantation in Congenitally Deaf Children

Wilkinson

Eisenberg²,

Krieger³

et al. 2017

Otology &Amp; Neurotology

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Objective To determine the safety and feasibility of the auditory brainstem implant (ABI) in congenitally deaf children with cochlear aplasia and/or cochlear nerve deficiency. Study Design Phase I feasibility clinical trial of surgery in 10 children, ages 2 to 5 years, over a 3 year period. Setting Tertiary children’s hospital and university-based pediatric speech/language/hearing center. Intervention(s) ABI implantation and post-surgical programming. Main outcome measure(s) The primary outcome measure is the number and type of adverse events during ABI surgery and post-surgical follow-up, including behavioral mapping of the device. The secondary outcome measure is access to and early integration of sound. Results To date, nine children are enrolled. Five children have successfully undergone ABI surgery and postoperative behavioral programming. Three children were screen failures, and one child is currently undergoing candidacy evaluation. Expected adverse events have been documented in three of the five children who received the ABI. One child experienced a cerebral spinal fluid (CSF) leak, which resolved with lumbar drainage. One child demonstrated vestibular side effects during device programming, which resolved by deactivating one electrode. One child experienced postoperative vomiting resulting in an abdominal radiograph. Four children have completed their 1-year followup and have speech detection thresholds of 30 to 35 dB HL. Scores on the IT-MAIS/MAIS range from 8 to 31 (out of a total of 40), and the children are demonstrating some ability to discriminate between closed-sets words that differ by number of syllables (pattern perception). Conclusions ABI surgery and device activation appears to be safe and feasible in this preliminary cohort.

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Section: Discussionmentioning

confidence: 70%

Initial Results of a Safety and Feasibility Study of Auditory Brainstem Implantation in Congenitally Deaf Children

Wilkinson

Eisenberg²,

Krieger³

et al. 2017

Otology &Amp; Neurotology

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“…Auditory and speech-perception outcomes. Speech perception was assessed once before surgery and again at 6 mo postactivation using the Speech Recognition Index in Quiet (SRI-Q) (29), following previous longitudinal CI studies (8,23,30). The SRI-Q consisted of a hierarchy of measures of speech-recognition abilities (see Materials and Methods for details).…”

Section: Resultsmentioning

confidence: 99%

Neural preservation underlies speech improvement from auditory deprivation in young cochlear implant recipients

Feng

Ingvalson

Grieco-Calub

et al. 2018

Proc. Natl. Acad. Sci. U.S.A.

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Although cochlear implantation enables some children to attain age-appropriate speech and language development, communicative delays persist in others, and outcomes are quite variable and difficult to predict, even for children implanted early in life. To understand the neurobiological basis of this variability, we used presurgical neural morphological data obtained from MRI of individual pediatric cochlear implant (CI) candidates implanted younger than 3.5 years to predict variability of their speech-perception improvement after surgery. We first compared neuroanatomical density and spatial pattern similarity of CI candidates to that of age-matched children with normal hearing, which allowed us to detail neuroanatomical networks that were either affected or unaffected by auditory deprivation. This information enables us to build machine-learning models to predict the individual children's speech development following CI. We found that regions of the brain that were unaffected by auditory deprivation, in particular the auditory association and cognitive brain regions, produced the highest accuracy, specificity, and sensitivity in patient classification and the most precise prediction results. These findings suggest that brain areas unaffected by auditory deprivation are critical to developing closer to typical speech outcomes. Moreover, the findings suggest that determination of the type of neural reorganization caused by auditory deprivation before implantation is valuable for predicting post-CI language outcomes for young children.

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“…For example, greater maternal sensitivity to communication needs of the child predicts better speech recognition performance (87); interpersonal family dynamics have not been explored at all in adult CI users. Similarly, the role of intensive postoperative aural rehabilitation has been emphasized in the pediatric population but has primarily been limited in adult CI users to patient-driven computerized auditory training (88).…”

Section: Introductionmentioning

confidence: 99%

The Enigma of Poor Performance by Adults With Cochlear Implants

Moberly

Bates

Harris

et al. 2016

Otology &Amp; Neurotology

122

117

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Objective Considerable unexplained variability and large individual differences exist in speech recognition outcomes for postlingually deaf adults who use cochlear implants (CIs), and a sizeable fraction of CI users can be considered “poor performers.” This paper summarizes our current knowledge of poor CI performance, and provides suggestions to clinicians managing these patients. Method Studies are reviewed pertaining to speech recognition variability in adults with hearing loss. Findings are augmented by recent studies in our laboratories examining outcomes in postlingually deaf adults with CIs. Results In addition to conventional clinical predictors of CI performance (e.g., amount of residual hearing, duration of deafness), factors pertaining to both “bottom-up” auditory sensitivity to the spectro-temporal details of speech, and “top-down” linguistic knowledge and neurocognitive functions contribute to CI outcomes. Conclusions The broad array of factors that contribute to speech recognition performance in adult CI users suggests the potential both for novel diagnostic assessment batteries to explain poor performance, and also new rehabilitation strategies for patients who exhibit poor outcomes. Moreover, this broad array of factors determining outcome performance suggests the need to treat individual CI patients using a personalized rehabilitation approach.

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A Prospective Longitudinal Study of U.S. Children Unable to Achieve Open-Set Speech Recognition 5 Years After Cochlear Implantation

Cited by 32 publications

References 51 publications

Initial Results of a Safety and Feasibility Study of Auditory Brainstem Implantation in Congenitally Deaf Children

Initial Results of a Safety and Feasibility Study of Auditory Brainstem Implantation in Congenitally Deaf Children

Neural preservation underlies speech improvement from auditory deprivation in young cochlear implant recipients

The Enigma of Poor Performance by Adults With Cochlear Implants

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