Factors Associated with Speech-Recognition Performance in School-Aged Children with Cochlear Implants and Early Auditory-Verbal Intervention

Abstract

Background Considerable variability exists in the speech recognition abilities achieved by children with cochlear implants (CIs) due to varying demographic and performance variables including language abilities. Purpose This article examines the factors associated with speech recognition performance of school-aged children with CIs who were grouped by language ability. Research Design This is a single-center cross-sectional study with repeated measures for subjects across two language groups. Study Sample Participants included two groups of school-aged children, ages 7 to 17 years, who received unilateral or bilateral CIs by 4 years of age. The High Language group (N = 26) had age-appropriate spoken-language abilities, and the Low Language group (N = 24) had delays in their spoken-language abilities. Data Collection and Analysis Group comparisons were conducted to examine the impact of demographic characteristics on word recognition in quiet and sentence recognition in quiet and noise. Results Speech recognition in quiet and noise was significantly poorer in the Low Language compared with the High Language group. Greater hours of implant use and better adherence to auditory-verbal (AV) therapy appointments were associated with higher speech recognition in quiet and noise. Conclusion To ensure maximal speech recognition in children with low-language outcomes, professionals should develop strategies to ensure that families support full-time CI use and have the means to consistently attend AV appointments.

Motor Processing in Children With Cochlear Implants as Assessed by Functional Near-Infrared Spectroscopy

“…Along with other reports on the same pediatric population ( Deroche et al, 2023 ; Koirala et al, 2023 ; Wolfe et al, 2021 ), we explored motor cortex activity and its association with visual and auditory networks in children with CIs. We found an increase in HbO and a decrease in HbR in the motor cortex of all participants, irrespective of their hearing and language status.…”

“…Seventy-five children between 7 and 18 years old were selected from patient records: 50 with CIs (CI group- Tables 1-A and 2-A ) and 25 controls with typical hearing and language development (TH group). Details about inclusion/exclusion criteria, participants’ demographic characteristics, hearing experience, and device use are provided in Wolfe et al (2021) , a study that reported exclusively on audiological outcomes. In the present study, CI recipients were divided into two groups based on their language skills: 26 children had age-appropriate language skills (referred to as Typical Language, or TL group) and 24 had language delays (referred to as Low Language, or LL group).…”

“…While CI technology has been effective in restoring hearing and allowing communication in quiet environments, there have been many cases in which users of these devices gained little benefit in important aspects of daily life. Concerning pediatric CI users, the research emphasis has often been on academic performance ( Marschark et al, 2007 ; Wilson Ottley et al, 2023 ) and some children have continued to struggle despite early implantation ( Ching et al, 2018 ; Dettman et al, 2016 ; Geers et al, 2017 ; Wolfe et al, 2021 ). The extent to which these differences stem from variable multimodal integration, language processing difficulties, or functional activation/deactivation of various brain regions has remained unclear.…”

Cross-modal plasticity in children with cochlear implant: converging evidence from EEG and fNIRS

“…Children in the LL group were tted with a hearing aid and then implanted at a later age than children in group HL. This difference might seem small (on average, about 17 vs. 7 months for hearing aid tting, and 27 vs. 20 months for rst implantation), but at such young ages, we know that this has repercussions for the development of speech recognition skills (Ching et (Wolfe et al, 2021). Forty-ve children were bilaterally implanted, all 26 from the HL group and 19 in the LL group.…”

“…Typically, multi-factorial models account for 50% of the variance (Sarant et al, 2001;Geers et al, 2003, and substantially less in adults e.g. Blamey et al, 2013;Lazard et al, 2012), using a combination of personal characteristics (cognitive skills, non-verbal intelligence, inherent language aptitudes), device parameters (electrode array, quality of mapping, and electric dynamic range), and communication mode (Geers et al, 2003;Dettman et al, 2013;Ambrose et al, 2015;Busch et al, 2019;Wolfe et al, 2021). We strongly suspect that the status of the auditory nerve and auditory brain (Feng et al, 2018;Sharma et al, 2002) would be additional factors to further explain why a given child derives much bene t from their device while another is not, despite both being implanted at a young age (Geers et al, 2016(Geers et al, , 2019.…”