Pediatric cochlear implantation

Yoon, Patricia J.

doi:10.1097/mop.0b013e32834618ec

Cited by 30 publications

(18 citation statements)

References 33 publications

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“…This was done in an effort to exclude those children who were deaf for many years and were well past the critical window for language development(8). We did not include children who did not undergo cochlear implantation because our programs do not routinely perform psychological testing on deaf children that our team members did not feel would be good candidates for cochlear implantation.…”

Section: Methodsmentioning

confidence: 99%

“…Approximately 2–3 in 1000 children are born with a significant degree of sensorineural hearing loss (7–8). It is estimated that about 25% of the cases of congenital hearing loss are attributed to identifiable prenatal or postnatal disease or trauma, 18% to undiagnosed genetic factors, 15% to autosomal dominant genetic mutations, 40% to autosomal recessive genetic mutations, and 2% to sex-linked genetic mutations(9).…”

Section: Introductionmentioning

confidence: 99%

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Cognitive Outcomes and Familial Stress After Cochlear Implantation in Deaf Children With and Without Developmental Delays

Oghalai

Caudle²,

Bentley³

et al. 2012

Otology &Amp; Neurotology

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Objective The benefits of cochlear implantation for children with developmental delays (DD) are often unclear. We compared cognition, adaptive behavior, familial stress, and communication in children with and without DD. Study Design Retrospective review Setting Two tertiary care pediatric hospitals Patients 204 children who underwent cochlear implantation assessed before and >1 year after implantation Main Outcome Measures The Mullen Scales of Early Learning (MSEL), Vineland Adaptive Behavior Scales (VABS), Parental Stress Index (PSI), and Preschool Language Scale (PLS). Results We developed a specific definition of DD for hearing-impaired children based upon DSM-IV criteria for mental retardation; 60 children met the criteria for DD and 144 children did not. Prior to implantation, multiple linear regression demonstrated that children with DD had lower scores in every domain of the MSEL and VABS (p<0.05) but no differences in any domains of the PSI and PLS (p>0.1) compared to children without DD. After implantation, children without DD demonstrated significant improvements in intelligence as measured by the MSEL, age-appropriate improvements in adaptive behavior as evaluated by the VABS, and their familial stress levels were not increased after cochlear implantation. In contrast, children with DD underwent implantation at a later age and demonstrated less comprehensive developmental improvements after cochlear implantation and higher stress levels. However, when the age differences were taken into account using multiple linear regression analyses, the differences between two cohorts were reduced. Conclusions These data indicate that our definition of DD is a reliable method of stratifying deaf children. While children with DD have a normal developmental rate of adaptive behavior after cochlear implantation, their developmental rate of intelligence is lower and they have higher stress levels than children without DD. However, our data suggest that if children with DD could be implanted as early as children without DD, their intelligence and stress outcomes would be improved.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cognitive Outcomes and Familial Stress After Cochlear Implantation in Deaf Children With and Without Developmental Delays

Oghalai

Caudle²,

Bentley³

et al. 2012

Otology &Amp; Neurotology

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“…The positive benefits of early diagnosis and cochlear implantation are well documented in the literature (Dettman et al ., 2007; Philips et al ., 2009; Ching et al ., 2009; Niparko et al ., 2010; Yoon, 2011; Geers et al ., 2011; Kral and Sharma, 2012). Parents and families have new expectations.…”

Section: Introductionmentioning

confidence: 99%

New expectations: Pediatric cochlear implantation in Japan

Oliver¹

2013

Cochlear Implants International

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Funding for cochlear implantsThe Japanese health-care system provides universal health coverage for the entire 127 million population of Japan. This includes all aspects of cochlear implantation, from diagnosis to implantation to mapping and habilitation aftercare. Japan has the third largest developed economy; however, the uptake rate for cochlear implants is lower than that of countries with similar economic status. Japan has an uptake rate of approximately 1% of potentially suitable subjects of all ages, compared with 5.6% in the USA.Cochlear implant provision for childrenIn Japan, about 55% of cochlear implant recipients are children of less than 18 years of age. This represents an increase of 20% in the last 10 years, with a relative increase in the numbers of children receiving implants compared with the numbers of adults. However, only 3–4% of children under the age of 3 years are being implanted at less than 18 months of age. This is in accordance with the Japanese ENT Academy's guidelines, which currently puts the minimum age limit for implants in children at 18 months.Neonatal screeningFor hearing loss was first piloted nationally in Japan in 2000. Funding for screening subsequently stopped in 2005, though the national treasury provided a further 2 years' funding. Since 2007 local government organizations have been given responsibility to support these screening programs, but there remains considerable variation in funding between different prefectures. In one prefecture, Okayama, 95% of babies were screened and followed up for 2 years. However, the support system for children who need further diagnostic testing after screening remains insufficient.ReferralWhen diagnosed, children with hearing loss are referred for counselling, hearing aids and habilitation. The responsibility for these is divided between the Ministry of Health and Welfare (including surgery, device programming, and therapy) and the Ministry of Education. Schools for the deaf and preschool hearing impaired education centers have had most of the responsibility for early intervention, educational choices and referral for cochlear implantation. In the past 98% of schools for children with hearing loss have used communication methods relying mostly on visual cues. In recent years, however, there has been a shift toward ‘inclusive’ mainstream education. Between 2008 and 2011 the number of children with cochlear implants in special needs schools increased to 16%. It is now estimated that 67% of children with cochlear implants may now be in mainstream schools.There is still the need for support services for these implanted children attending mainstream schools, with adequate provision of resources.ConclusionCochlear Implantation has had a significant role in changing the medical management and education of children in Japan with hearing loss. Much remains to be done, though the situation has greatly improved in recent years and continues to do so.

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“…This seems to stand in contrast to other studies that report a greater benefit for children with early implantation over children with later interventions (7,25,26). This might be due to different reasons: first, when having a closer look at studies that reported better outcomes with earlier intervention, these often describe developmental aspects with the trajectory of aural rehabilitation.…”

Section: Discussionmentioning

confidence: 64%