The Influence of Age at Implantation on Performance With a Cochlear Implant in Children

Kileny, Paul R.; Zwolan, Teresa A.; Ashbaugh, Carissa

doi:10.1097/00129492-200101000-00008

Cited by 68 publications

(53 citation statements)

References 9 publications

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“…The difference in the age ranges, 3 versus 11 years, could lead to different results. Additionally, age at implantation effects have been found for other outcomes in other studies (Connor et al, 2000;Kileny et al, 2001;Kirk et al, 2002;Sharma, Dorman, & Spahr, 2002;Tyler et al, 2001). Importantly, these studies all shared the common finding that stronger language skills (vocabulary or syntax) are associated with stronger reading skills (Geers, 2003;.…”

Section: Vocabulary and Communication Methodssupporting

confidence: 54%

“…Further, converging research indicates that multiple factors affect performance with the cochlear implant, including age at implantation (Connor, 1998; Connor, Hieber, Arts, & Zwolan, 2000;Kileny, Zwolan, & Ashbaugh, 2001;Tyler et al, 2001), age at onset of deafness (Geers, 2002;Geers et al, 2002;Osberger, 1994), pre-implant residual hearing (Zwolan et al, 1997), length of cochlear implant use (Tye-Murray et al, 1995), family characteristics (Geers, 2002;Geers et al, 2002), type of device (Connor et al, 2000), and device functioning (Geers, 2002;Geers et al, 2002). Research on the effect of communication method has been equivocal (Ash, Hodges, Butts, Schloffman, & Balkany, 1997; Connor et al., 2000; Cullington, Hodges, Butts, Donal-Ash, & Balkany, 2001; Geers et al, 2001;Hodges, Dolan, Balkany, Schloffman, & Butts, 1999;Miyamoto et al, 1999;Ninio, 1983;Zimmerman-Phillips & Murad, 1997).…”

Section: Abstract: Deafness Literacy Language Development Communimentioning

confidence: 99%

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Examining Multiple Sources of Influence on the Reading Comprehension Skills of Children Who Use Cochlear Implants

Connor

Zwolan

2004

J Speech Lang Hear Res

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155

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Children with profound deafness are at risk for serious reading difficulties. Multiple factors affect their development of reading skills, including use of cochlear implants. Further, multiple factors influence the overall success that children experience with their cochlear implants. These factors include the age at which they receive an implant, method of communication, vocabulary skills, preoperative residual hearing, and socioeconomic status. Ninety-one children with prelingual and profound hearing impairments who received cochlear implants at varying ages participated in the study. Structural equation modeling confirmed that multiple factors affected young cochlear implant users' reading comprehension skills and that there were significant associations between the predictors of reading comprehension. Pre-implant vocabulary had an indirect positive effect on reading through postimplant vocabulary, which had a direct positive effect on reading. Overall, children with stronger language skills demonstrated stronger reading outcomes. Age at implantation both directly and indirectly, through postimplant vocabulary, affected reading outcomes, and the total effect was large. Children who were younger when they received their implants tended to have higher reading comprehension scores. Socioeconomic status negatively affected reading. Children who used total communication prior to implantation tended to have stronger pre-implant vocabulary scores, but the total effect of pre-implant communication method on children's reading skills was negligible. Research and educational implications are discussed. KEY WORDS: deafness, literacy, language development, communication, sign language, socioeconomic status (SES)C hildren with profound hearing losses are at particular risk for serious reading difficulties. On average, these children graduate from high school with reading skills at a third-grade level (Allen, 1986;Holt, 1994). This gap in reading achievement between children with hearing impairment and children with normal hearing sensitivity widens as severity of hearing loss increases (Karchmer, Milone, & Wolk, 1979). In recent and separate studies, use of cochlear implants (L. Spencer, Tomblin, & Gantz, 1998;Svirsky, Stallings, Lento, Ying, & Leonard, 2002;Szagun, 2001;Tomblin, Spencer, Flock, Tyler, & Ganz, 1999) and early exposure to sign language (Padden & Ramsey, 1998 have been positively associated with vocabulary and literacy skills. Further, multiple factors affect the reading skills of children with cochlear implants (Geers, 2002(Geers, ,2003Geers et al., 2002;Rayner, Foorman, Perfetti, Pesetsky, & Seidenberg, 2001), just as multiple factors affect the reading skills of children with normal hearing sensitivity (Geers, 2002;Geers et al., 2002;Rayner et al., 2001). Although there is research that has explored the multiples sources that affect reading skills among children with profound hearing losses, there is little research that has used multilevel modeling. The chief advantage of multilevel models is that they ...

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Section: Vocabulary and Communication Methodssupporting

confidence: 54%

Section: Abstract: Deafness Literacy Language Development Communimentioning

confidence: 99%

Examining Multiple Sources of Influence on the Reading Comprehension Skills of Children Who Use Cochlear Implants

Connor

Zwolan

2004

J Speech Lang Hear Res

Self Cite

155

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“…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).…”

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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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“…Similarly, a positive relationship has been shown between early age at implantation and enhanced cochlear implant (CI) performance in children. [3][4][5] There is little information, however, concerning the effect of age at implantation on meaningful listening skills in children as young as 12 months who undergo implantation. Evaluating device benefit in these young children poses significant challenges.…”

mentioning

confidence: 99%

Effect of Age at Cochlear Implantation on Auditory Skill Development in Infants and Toddlers

Robbins¹,

Koch²,

Osberger³

et al. 2004

Arch Otolaryngol Head Neck Surg

278

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The Influence of Age at Implantation on Performance With a Cochlear Implant in Children

Abstract: These results confirm previous findings indicating continued improvement of speech recognition with time in implanted children. Furthermore, the results support the concept of the advantage of a younger age at implantation.

Cited by 68 publications

References 9 publications

Examining Multiple Sources of Influence on the Reading Comprehension Skills of Children Who Use Cochlear Implants

Examining Multiple Sources of Influence on the Reading Comprehension Skills of Children Who Use Cochlear Implants

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

Effect of Age at Cochlear Implantation on Auditory Skill Development in Infants and Toddlers

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