Prelingually Deafened Children??s Performance With the Nucleus Multichannel Cochlear Implant

Miyamoto, Richard T.; Osberger, Mary Joe; Robbins, Amy McConkey; Myres, Wendy A.; Kessler, K.

doi:10.1097/00129492-199309000-00004

Cited by 47 publications

(39 citation statements)

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“…They also suggested that CPT performance was unlikely to be related to speech and language outcomes in the children with cochlear implants because gains in linguistic skills typically emerge more slowly over time, after several years of cochlear implant use (Fryauf-Bertschy, Tyler, Kelsay, & Gantz, 1992;Miyamoto, Osberger, Robbins, Myres, & Kessler, 1993). However, Quittner et al did not report any speech and language outcome data, nor did they assess the relations between CPT performance and speech/language outcomes in either of their two experiments.…”

Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

Development of Visual Attention Skills in Prelingually Deaf Children Who Use Cochlear Implants

et al. 2005

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Objective-To determine the effects of length of cochlear implant use and other demographic factors on the development of sustained visual attention in prelingually deaf children and to examine the relations between performance on a test of sustained visual attention and audiological outcome measures in this population.Design-A retrospective analysis of data collected before cochlear implantation and over several years after implantation. Two groups of prelingually deaf children, one >6 years old (N = 41) and one <6 years old (N = 47) at testing, were given an age-appropriate Continuous Performance Task (CPT). In both groups, children monitored visually presented numbers for several minutes and responded whenever a designated number appeared. Hit rate, false alarm rate, and signal detection parameters were dependent measures of sustained visual attention. We tested for effects of a number of patient variables on CPT performance. Multiple regression analyses were conducted to determine if CPT scores were related to performance on several audiological outcome measures.Results-In both groups of children, mean CPT performance was low compared with published norms for normal-hearing children, and performance improved as a function of length of cochlear implant use and chronological age. The improvement in performance was manifested as an increase in hit rate and perceptual sensitivity over time. In the younger age group, a greater number of active electrodes predicted better CPT performance. Results from regression analyses indicated a relationship between CPT response criterion and receptive language in the younger age group. However, we failed to uncover any other relations between CPT performance and speech and language outcome measures.Conclusions-Our findings suggest that cochlear implantation in prelingually deaf children leads to improved performance on a test of sustained visual processing of numbers over 2 or more years of cochlear implant use. In preschool-age children who use cochlear implants, individuals who are more conservative responders on the CPT show higher receptive language scores than do individuals with more impulsive response patterns. Theoretical accounts of these findings are discussed, including cross-modal reorganization of visual attention and enhanced phonological encoding of visually presented numbers.Prelingually deaf children with cochlear implants are a unique clinical population to study because they have experienced a period of auditory deprivation before the development of significant speech and language skills. The success of many deaf children in acquiring Copyright © 2005 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript spoken language from the electrical stimulation provided by a cochlear implant is impressive. Although clinical outcomes have been found to be quite variable in this population Pisoni, Cleary, Geers, & Tobey, 2000;Sarant, Blamey, Dowell, Clark, & Gibson, 2001), the scores of most children on a range of speech perception, langua...

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Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

Development of Visual Attention Skills in Prelingually Deaf Children Who Use Cochlear Implants

et al. 2005

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“…Two yr postimplantation, children with prelingual deafness may demonstrate improved pattern recognition, improved word and phoneme identification, and in some cases, open-set word recognition (Fryauf-Bertschy, Tyler, Kelsay, & Gantz, 1992;Fryauf-Bertschy, Tyler, Kelsay, Gantz & Woodworth, 1997;Miyamoto, Osberger, Robbins, Myres, & Kessler, 1993;Staller, Beiter, Brimacombe, Mecklenburg, & Arndt, 1991). There is some evidence that a CI provides information that allows children to perceive the segments of the speech signal that correspond to inflectional endings.…”

Section: Speech Perceptionmentioning

confidence: 99%

The Production of English Inflectional Morphology, Speech Production and Listening Performance in Children with Cochlear Implants

1998

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Objective-To compare how children who use either cochlear implants (CIs) or hearing aids (HAs) express English inflectional morphemes during conversation, i.e., with voice, with sign, or with both. A secondary objective was to investigate the relationship between morpheme use in pediatric CI users and their speech perception skills, length of experience with the device, and accuracy of phoneme production.Design-Group 1 consisted of 25 children who used CIs, and Group 2 consisted of 13 children who used HAs. All children were prelingually deafened and all used simultaneous communication. A 12 minute spontaneous conversation was elicited, transcribed and coded. Between group comparisons were performed to evaluate differences in modality and number of morphemes used. Additionally, use of morpheme endings was related to length of CI experience, accuracy of phoneme production, and closed-set speech recognition performance.Results-Children who had CI experience produced significantly more English inflected morphemes than children in the HA group. CI participants also expressed the inflected endings by using voice-only mode 91% of the time, whereas HA participants used voice-only mode 1% of the time. In the CI group, a strong relationship was found between number of morpheme endings used and speech recognition scores, length of CI experience and accuracy of phoneme production. The results of this study indicate that input from the CI facilitates children's ability to perceive and comprehend bound morphemes.This investigation focused on the use of English inflectional morphology by young cochlear implant (CI) users who communicate primarily with Signed English. Our goal was to evaluate the acquisition of inflectional endings, and to explore the role of CI use in their development. The first section of the following review indicates that little research exists concerning the language skills of young CI users. In the next sections, we note that these children often acquire the speech skills necessary to produce the sounds associated with plurals and third person possessive, /s, z/, past tense /t, d/, as well as the /m/ associated with first person possessive (i.e., I'm), and the /ng/ associated with the present progressive tense. As will be noted, CI children can often hear these sounds, so they may receive exposure to them during everyday listening. Robbins, Osberger, Miyamoto, & Kessler, 1995).Improvements in receptive and expressive vocabulary and syntax skills often follow receipt of a CI (Geers & Moog, 1994;Miyamoto, Osberger, Robbins, Myres, Kessler, & Pope, 1992). For instance Miyamoto et al. (1992) reported small improvements in receptive vocabulary in a group of children after they used a CI for 2.5 yr as indexed by quotient scores on the Peabody Picture Vocabulary Test-Revised (Dunn & Dunn, 1981). Geers and Moog (1994) reported that after 3 yr of devise use, children who used CIs performed better than children who used hearing aids (HAs) on the receptive language test, Rhode Island Test of Language Stru...

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“…A secondary aim was to examine differences in cost-effectiveness between different groups of candidates for implantation. Justification for this secondary aim is provided by evidence that the clinical and demographic characteristics of children influence many outcomes from implantation, including speech perception (e.g., Miyamoto, Osberger, Robbins, Myres, & Kessler, 1993;Tyler, Fryauf-Bertschy, Gantz, Kelsay, & Woodworth, 1997), spoken language, auditory performance, speech intelligibility, academic abilities , and the cost of education (Barton, Stacey, Fortnum, & Summerfield, 2006a;Schulze-Gattermann, Illg, Schoenermark, Lenarz, & Lesinski-Schiedat, 2002). It is possible therefore that the cost-effectiveness of implantation also varies according to the characteristics of the child.…”

mentioning

confidence: 99%

“…It is possible therefore that the cost-effectiveness of implantation also varies according to the characteristics of the child. We focus on three characteristics which have previously been shown to exert a positive influence on the benefit associated with implantation: a younger age at implantation (Kileny, Zwolan, & Ashbaugh, 2001;Kirk, Miyamoto, Lento, Ying, O'Neill, & Fears, 2002;Miyamoto, et al, 1993;Nikolopoulos, O'Donoghue, & Archbold, 1999;Sharma, Dorman, & Spahr, 2002;Stacey, et al, 2006;Svirsky, Teoh, & Neuburger, 2004;Tyler, et al, 1997), a greater duration of implant use Tyler, et al, 1997), and a poorer preoperative average hearing level (AHL) Tyler, et al, 1997). If the cost-effectiveness of implantation varied with any of these variables, then it could be more cost-effective to implant some groups of children than others (e.g., younger children in preference to older children, or children with less favorable AHLs in preference to children with more favorable AHLs).…”

mentioning

confidence: 99%

Hearing-Impaired Children in the United Kingdom, IV: Cost-Effectiveness of Pediatric Cochlear Implantation

et al. 2006

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Objective: To estimate the cost-effectiveness of pediatric cochlear implantation by conducting a costutility analysis from a societal perspective. Design:In a cross-sectional survey, the parents of a representative sample of hearing-impaired children assessed the health utility of their child using a revised version of the Health Utilities Index Mark III questionnaire. Linear regression was used to estimate the gain in health utility associated with implantation while controlling for eight potentially confounding variables: average (4-frequency, unaided, preoperative) hearing level (AHL), age at onset of hearing-impairment, age, gender, number of additional disabilities, parental occupational skill level, ethnicity, and parental hearing status. The gain in health utility was accumulated to estimate the number of quality-adjusted life years (QALYs) that would be gained from implantation over 15 yr and over a child's lifetime. The incremental societal cost of implantation, calculated in euros (€) at 2001/2 levels, was estimated by summing the incremental costs of implantation that are incurred in the health sector, in the education sector, and by the child's family. The cost-effectiveness of cochlear implantation was estimated by calculating the incremental societal cost per QALY gained and was compared with an upper limit of acceptability of €50,000 per QALY. Results:The parents of 403 implanted children, and 1863 nonimplanted children, completed the health utility questionnaire. Higher health utility was associated with a more favorable AHL, an older age at onset of hearing impairment, female gender, having fewer additional disabilities, having parents with a greater occupational skill level, white ethnicity, and implantation. The gain in health utility associated with implantation was estimated to be higher for children with a worse preoperative AHL and who were implanted when younger. Over 15 yr, for a child implanted at age 6 with a preoperative loss of 115 dB, 2.23 QALYs were estimated to be gained, compared with a mean incremental societal cost of €57,359, yielding a mean cost per QALY of €25,629.Cost-effectiveness was more favorable: (1) when estimated over a child's lifetime rather than 15 yr, (2) for children with a worse preoperative AHL, and (3) for children who were implanted when younger. Conclusions:The mean cost of gaining a QALY for the children in the present sample falls within acceptable limits. The strategy of giving highest priority for implantation to children with the greatest loss of hearing, and who are younger, maximizes benefit for a given cost.

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Prelingually Deafened Children??s Performance With the Nucleus Multichannel Cochlear Implant

Cited by 47 publications

References 0 publications

Development of Visual Attention Skills in Prelingually Deaf Children Who Use Cochlear Implants

Development of Visual Attention Skills in Prelingually Deaf Children Who Use Cochlear Implants

The Production of English Inflectional Morphology, Speech Production and Listening Performance in Children with Cochlear Implants

Hearing-Impaired Children in the United Kingdom, IV: Cost-Effectiveness of Pediatric Cochlear Implantation

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