Performance of multiply handicapped children using cochlear implants

Waltzman, Susan B.; Scalchunes, V.; Cohen, Noel L.

doi:10.1016/s0196-0709(00)80040-x

Cited by 128 publications

(110 citation statements)

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“…It is often difficult in an infant to be aware of the presence of and/or diagnose learning disabilities, cognitive deficits, or other variables that potentially can hinder the ability of a child to make use of the auditory information being accessed via the cochlear implant. 23,24 During preoperative counseling, clinicians need to address this possibility with the parents to ensure that expectations regarding the child's progress are realistic. Not emphasizing that every child is different and that some children as a result of the potential presence of negative confounding factors may not achieve a high level of performance could lead to great dissatisfaction, frustration, and distress on the part of the parents.…”

Section: Discussionmentioning

confidence: 99%

Cochlear Implantation in Children Younger Than 12 Months

2005

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ABSTRACT. Objectives. As a result of universal newborn hearing screening and improved evaluation tools, many children with severe to profound hearing loss are being diagnosed as infants. This affords the opportunity to provide these children access to cochlear implantation, although medical and audiologic challenges must be addressed. The purpose of this study was to investigate the safety and efficacy of cochlear implantation in children who are younger than 1 year.Methods. A prospective study was conducted of 18 children who had confirmed severe to profound sensorineural hearing loss and received cochlear implants at our medical center before 12 months of age. The length of device usage ranged from 6 months to 4 years, 5 months. The main outcomes measured were perioperative and postoperative surgical/medical aspects, the InfantToddler Meaningful Auditory Integration Scale and ageappropriate phoneme, and word and sentence recognition tests, when appropriate.Results. All children had full insertions of the electrode array without surgical complications and are developing age-appropriate auditory perception and oral language skills.Conclusions. Early implantation is feasible and beneficial in some children who are younger than 12 months and should be considered with attention to variables involved in the decision-making process, including possible increased surgical risk, skull size and scalp thickness, and mastoid development. U niversal newborn hearing screening has allowed for the identification of severe to profound hearing loss at birth or within a few months thereafter. Because universal hearing screening programs have been and continue to be established throughout the United States, between 85% and 99% of newborns are being screened for hearing loss within 1 day of being born, with the remainder being tested within the first few months of life. This new population of hearing-impaired infants, who by virtue of the extent of their hearing losses are possible candidates for cochlear implantation, provides new opportunities and challenges.Research over time has demonstrated that the early identification of significant hearing loss followed by intervention procedures, including hearing aid usage commencing during the first 6 months of life, significantly increases the level of language development, speech intelligibility, and emotional stability as compared with children with later identification and intervention. 1-3 On average and over all degrees of hearing loss, children achieve higher levels in linguistic, academic, and social skills when management of hearing loss commences at an early age. Because much achievement in the world is based on linguistic competence, the ability of children to communicate often defines many aspects of their educational and social development. Consequently, the window of opportunity for language learning is critical to overall childhood development. For the most part, those critical years have been determined to be from birth to ϳ7 years of age, by which time the majority of th...

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Section: Discussionmentioning

confidence: 99%

Cochlear Implantation in Children Younger Than 12 Months

2005

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“…For example, in one of the first studies of these children, (Pyman et al, 2000) found that although 90% of 75 children with motor and/or cognitive delays could discriminate consonants and vowels after four years of cochlear implant use, only around 60% of the children were able to use this information to perceive open-set sentences (those presented with no context), compared to over 80% of children without additional disabilities. Similarly, a further study of children with a variety of disabilities, such as attention-deficit disorder, cerebral palsy, central auditory processing disorder, dyspraxia and autism, showed some speech perception skill development at a slower rate than for the general population (Waltzman et al, 2000). Children whose additional disability is mild can derive significant benefit from cochlear implants, whereas children with more severe disabilities have much less favourable outcomes, with some showing almost no progress (Edwards, Frost & Witham, 2006;Filipo et al, 2004;Hamzavi et al, 2000;Meinzen-Derr et al, 2011;Vlahovic & Sindija, 2004).…”

Section: Children With Additional Disabilities: Implications For Candmentioning

confidence: 95%

“…Children whose additional disability is mild can derive significant benefit from cochlear implants, whereas children with more severe disabilities have much less favourable outcomes, with some showing almost no progress (Edwards, Frost & Witham, 2006;Filipo et al, 2004;Hamzavi et al, 2000;Meinzen-Derr et al, 2011;Vlahovic & Sindija, 2004). Most studies have highlighted that children with additional disabilities require longer periods of implant use before demonstrating any benefit, and as for children in the general cochlear implant population, variation in outcomes is wide for children with additional disabilities (Hamzavi et al, 2000;Waltzman et al, 2000). It was reported for some children that the assessment tasks were too difficult to complete (Donaldson et al, 2004;Waltzman et al, 2000), which is a factor that has added to the difficulty of determining outcomes for this population.…”

Section: Children With Additional Disabilities: Implications For Candmentioning

confidence: 99%

“…Most studies have highlighted that children with additional disabilities require longer periods of implant use before demonstrating any benefit, and as for children in the general cochlear implant population, variation in outcomes is wide for children with additional disabilities (Hamzavi et al, 2000;Waltzman et al, 2000). It was reported for some children that the assessment tasks were too difficult to complete (Donaldson et al, 2004;Waltzman et al, 2000), which is a factor that has added to the difficulty of determining outcomes for this population.…”

Section: Children With Additional Disabilities: Implications For Candmentioning

confidence: 99%

“…Some of the observed benefits cannot be quantified on standardised tests, and have been instead reported anecdotally, with observations of improvements in social interaction and responsiveness to the environment, behaviour, vocalization, self-help skills, motor skills and the ability to follow instructions (Donaldson et al, 2004;Filipo et al, 2004;Fukuda et al, 2003;Waltzman et al, 2000;Wiley et al, 2005). There is still a need to determine the impact of additional disabilities on post-operative benefit with cochlear implants, and to define more clearly what benefits might reasonably be expected for children with different additional disabilities.…”

Section: Children With Additional Disabilities: Implications For Candmentioning

confidence: 99%

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