Eight of ten children use their cochlear implant consistently on a daily basis. Two children who were equipped with an implanted device at a later age tend to nonuse of the device. The evaluation of binaural hearing in small children is still difficult and methods have to be developed to allow objective assessment.
The aims of the present multi-center study were to investigate the extent of mental health problems in adolescents with a hearing loss and cochlear implants (CIs) in comparison to normal hearing (NH) peers and to investigate possible relations between the extent of mental health problems of young CI users and hearing variables, such as age at implantation, or functional gain of CI. The survey included 140 adolescents with CI (mean age = 14.7, SD = 1.5 years) and 140 NH adolescents (mean age = 14.8, SD = 1.4 years), their parents and teachers. Participants were matched by age, gender and social background. Within the CI group, 35 adolescents were identified as “risk cases” due to possible and manifest additional handicaps, and 11 adolescents were non-classifiable. Mental health problems were assessed with the Strengths and Difficulties Questionnaire (SDQ) in the versions “Self,” “Parent,” and “Teacher.” The CI group showed significantly more “Peer Problems” than the NH group. When the CI group was split into a “risk-group” (35 “risk cases” and 11 non-classifiable persons) and a “non-risk group” (n = 94), increased peer problems were perceived in both CI subgroups by adolescents themselves. However, no further differences between the CI non-risk group and the NH group were observed in any rater. The CI risk-group showed significantly more hyperactivity compared to the NH group and more hyperactivity and conduct problems compared to the CI non-risk group. Cluster analyses confirmed that there were significantly more adolescents with high problems in the CI risk-group compared to the CI non-risk group and the NH group. Adolescents with CI, who were able to understand speech in noise had significantly less difficulties compared to constricted CI users. Parents, teachers, and clinicians should be aware that CI users with additionally special needs may have mental health problems. However, peer problems were also experienced by CI adolescents without additional handicaps.
All children consistently use their CI 1 year postimplant. Our preliminary results suggest binaural hearing benefits for speech understanding in noise, localization ability and subjectively perceived hearing ability for school-aged children with UHL. Trends for CI-benefits in younger preschoolaged children are confirmed through subjective assessment reported by the parents. The benefits in hearing performance suggest binaural integration and processing of electric and acoustic stimulation arriving at 2 different ears is possible for children with UHL.
Zusammenfassung Hintergrund Die Rehabilitation nach CI(Cochleaimplantat)-Operation erfolgt leitliniengerecht durch eine multimodale Therapie, technische Anpassungen des Sprachprozessors und medizinische Nachsorge. Zu Zeiten der Corona-Pandemie wurde für die Patienten der Zugang zur auditorischen Rehabilitation verzögert oder erschwert. Die neuen Hygienemaßnahmen durch die SARS-Cov-2-Pandemie verändern auch die medizinische Nachsorge und Rehabilitation nach CI. Ziel der Untersuchung war es, die Qualität der Rehabilitation unter Corona-Bedingungen zu evaluieren. Material und Methoden Wir führten eine anonyme Befragung erwachsener Rehabilitanden mittels nichtstandardisiertem Fragebogen durch. Beurteilt wurden im Vergleich zu den Voraufenthalten die Qualität der ärztlichen Betreuung, der Sprach- und Musiktherapie, der technischen Anpassung und der psychologischen Betreuung sowie der Einsatz der Hygienemaßnahmen. Ergebnisse Insgesamt 109 Rehabilitanden beantworteten den Fragebogen. Die Qualität der Rehabilitation und der Therapien wurde als qualitativ unverändert oder besser eingeschätzt. Die Gefährlichkeit der Pandemie, aber auch die Angst in der derzeitigen Situation gaben die Rehabilitanden zu einem unerwartet hohen Prozentsatz mit 68 bzw. 50 % an. Gleichzeitig konnten die getroffenen Hygienemaßnahmen die Patienten subjektiv während des Aufenthalts entlasten. Der Mund-Nasen-Schutz war für die Mehrheit sehr störend, Visiere, Spuckschutz bzw. Abstandsgebot wurden eher toleriert. Schlussfolgerungen Die Umsetzung der Hygienemaßnahmen im therapeutischen Setting der CI-Rehabilitation wird von den Rehabilitanden akzeptiert und erlaubt den Zugang zur auditorischen Rehabilitation. Ziel einer erfolgreichen CI-Rehabilitation sollte eine möglichst angstfreie Behandlung unter Wahrung der Hygieneregeln sein.
Background The rehabilitation process following cochlear implant (CI) surgery is carried out in a multimodal therapy according to German national guidelines and includes technical and medical aftercare. In times of the corona pandemic surgery and rehabilitation appointments were cancelled or delayed leading to a more difficult access to auditory rehabilitation. Newly implemented hygiene modalities due to the SARS-CoV‑2 pandemic have changed medical aftercare and the rehabilitation process. The aim of this study was to evaluate the quality of rehabilitation under corona conditions. Material and methods An anonymous survey of adult cochlear implant patients was carried out by a non-standardized questionnaire. Demographics were analyzed and the quality of medical aftercare, speech therapy, technical aftercare, psychological support and the hygiene modalities were compared to previous rehabilitation stays. Results In total 109 patients completed the questionnaire. The quality of rehabilitation and individual therapy were rated as qualitatively similar or improved. The threat of the pandemic and fear of corona were rated unexpectedly high with 68% and 50%, respectively. The hygiene measures during the rehabilitation stay eased subjective fears at the same time. The majority of patients were annoyed by wearing face masks but visors, protection shields and social distancing were more tolerated. Conclusion The implementation of the new hygiene modalities within the therapeutic rehabilitation setting was well-accepted by patients allowing access to auditory rehabilitation. A successful rehabilitation should ensure a fear-free environment by adhering to the necessary hygiene modalities.
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