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BACKGROUND: In order to optimise the support of children with cochlear implants (CI), it is very important to detect slow developmental processes as early as possible. Data from the LittlEARS® Auditory Questionnaire (LEAQ) from children with early bilateral CI are evaluated and presented in relation to age and hearing age and compared with language development data recorded later. MATERIALS AND METHODS: This retrospective multicentre study included data from a total of 554 children for whom at least one LEAQ was completed during the course of CI rehabilitation. Children without additional disabilities who received bilateral simultaneous or sequential CI treatment were included. RESULTS: As expected, there are high correlations between hearing age (HA) and the overall LEAQ total score. When analysed according to chronological age (CA), development runs roughly parallel to the development of children with normal hearing, albeit at a lower level. Children implanted early up to an age of ≤ 12 months consistently achieve approximately 7-8 raw points more. Only the LEAQ results of the later test times (from the age of 18 months) correlate with some areas of the speech development test for children (SETK; areas 3-5). CONCLUSION: The earliest possible detection of critical developmental processes in children with CI is extremely important. In the case of very early CI fitting, the CA should be used as a reference measure in diagnostics. The LEAQ values determined for the group of children with CI are suitable to a limited extent as generally valid reference values for children with early bilateral CI. Further studies should continue to work out the correlations between early preverbal development and later speech development.

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PURPOSE: The aim of this study was to investigate whether the fitting data of children with Cochlear implants (CI) and severe additional disabilities (CAD) differ compared to children with CI but without additional disabilities (CnonAD). METHODS: In this retrospective analysis, 76 CI cases (fitted ears) from CAD were included and matched with 76 cases from CnonAD. The subjective set values, such as pulse width (PW), threshold (T) and most comfortable (MC) levels were recorded. Additionally, the response threshold values by means of aided soundfield threshold (AST), the values of the intracochlear electrode impedances, the eCAP thresholds and the daily wearing time by using data logging were recorded and analysed. RESULTS: The T and MC levels for the Medel implants were significantly lower in the sample than in the control group. A similar trend was evident for Cochlear® implants. The sample showed a positive correlation between the eCAP thresholds and the T level and MC level in case of the Cochlear implants. The CAD group showed a significantly higher aided soundfield threshold. In contrast to the CnonAD (0%), there was a total of 18% in the CAD with a reduced daily wearing time. When these were excluded, eCAP thresholds were significantly higher in the CAD group. In addition, there was a trend for eCAP thresholds to be higher if the contralateral ear was not also fitted with a CI. CONCLUSIONS: The significantly higher eCAPs in CAD may be explained by different neural survival but also by different fittings and MC levels. The audiuologist's subjectivity must be considered as a potential bias but also as potentially valuable input variable contributing to the variance in the fitting parameters and outcomes. Better fitting of T and MC levels focusing on behavioural and developmental responses may lead to a longer wearing time. To support the audiologist and the fitting process, it is necessary to interpret the response thresholds in the aided soundfield threshold against the background of the medical diagnosis and observations from everyday life should be considered. To ensure optimal development of CAD children according to their individual abilities, a multi-professional, family-centred intervention programme including videoanalyses should be implemented at an early stage, ideally from the decision process for a cochlear implant.

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PURPOSE: The adaptation of existing questionnaires is a valuable method to make instruments available in multiple languages. It is necessary to assure the quality of an adaptation by following adaptation guidelines. The Cochlear Implant Quality of Life-35 Profile (CIQOL-35 Profile) was developed and validated to measure the functional abilities in English-speaking adult CI users but is not yet available in German. In this study, we performed a cross-cultural adaptation of this instrument to make it applicable in research and rehabilitation with German-speaking patients. METHOD: This study followed established practice guidelines for translating and adapting hearing-related questionnaires. Professional translators and health care professionals with experience with patients with hearing loss translated all items forward and backward multiple times. A committee reviewed the process and decided when a satisfactory consensus was achieved. Next, we examined the intelligibility of the German version using cognitive interviews with 15 adult CI users. RESULTS: For most items, there was no difficulty with direct translation. In items that turned out to be more difficult to translate, it proved to be very helpful to compare the back translation to the original version, discuss the wording in the committee, and ask the source-language questionnaire developer. During the interviews, issues of comprehension for some phrases were identified. These phrases were changed according to the participant's questions and suggestions. CONCLUSIONS: The CIQOL-35 Profile was successfully adapted into German. The German version of the questionnaire is now available for research and clinical practice. Further validation of the German CIQOL-35 Profile is in progress. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25386571.

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INTRODUCTION: Individuals with intellectual disabilities (ID) often suffer from hearing loss, in most cases undiagnosed or inappropriately treated. The implementation of a programme of systematic hearing screening, diagnostics, therapy initiation or allocation and long-term monitoring within the living environments of individuals with ID (nurseries, schools, workshops, homes), therefore, seems beneficial. METHODS AND ANALYSIS: The study aims to assess the effectiveness and costs of a low-threshold screening programme for individuals with ID. Within this programme 1050 individuals with ID of all ages will undergo hearing screening and an immediate reference diagnosis in their living environment (outreach cohort). The recruitment of participants in the outreach group will take place within 158 institutions, for example, schools, kindergartens and places of living or work. If an individual fails the screening assessment, subsequent full audiometric diagnostics will follow and, if hearing loss is confirmed, initiation of therapy or referral to and monitoring of such therapy. A control cohort of 141 participants will receive an invitation from their health insurance provider via their family for the same procedure but within a clinic (clinical cohort). A second screening measurement will be performed with both cohorts 1 year later and the previous therapy outcome will be checked. It is hypothesised that this programme leads to a relevant reduction in the number of untreated or inadequately treated cases of hearing loss and strengthens the communication skills of the newly or better-treated individuals. Secondary outcomes include the age-dependent prevalence of hearing loss in individuals with ID, the costs associated with this programme, cost of illness before-and-after enrolment and modelling of the programme's cost-effectiveness compared with regular care. ETHICS AND DISSEMINATION: The study has been approved by the Institutional Ethics Review Board of the Medical Association of Westphalia-Lippe and the University of Münster (No. 2020-843 f-S). Participants or guardians will provide written informed consent. Findings will be disseminated through presentations, peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBER: DRKS00024804.

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Students who are deaf or hard-of-hearing (DHH) often show significant difficulties in learning mathematics. Previous studies have reported that students who are DHH lag several years behind in their mathematical development compared to hearing students. As possible reasons, limited learning opportunities due to a lesser incidental exposure to numerical ideas, delays in language and speech development, and further idiosyncratic difficulties of students who are DHH are discussed; however, early mathematical skills and their role in mathematical difficulties of students who are DHH are not explored sufficiently. In this study, we investigate whether students who are DHH differ from hearing students in their ability to enumerate small sets (1-9)-an ability that is associated with mathematical difficulties and their emergence. Based on a study with N = 63 who are DHH and N = 164 hearing students from third to fifth grade attempting 36 tasks, we used eye tracking, the recording of students' eye movements, to qualitatively investigate student enumeration processes. To reduce the effort of qualitative analysis of around 8,000 student enumeration processes (227 students x 36 tasks), we used Artificial Intelligence, in particular, a clustering algorithm, to identify student enumeration processes from the heatmaps of student gaze distributions. Based on the clustering, we found that gaze distributions of students who are DHH and students with normal hearing differed significantly on a group level, indicating differences in enumeration processes, with students who are DHH using advantageous processes (e.g., enumeration "at a glance") more often than hearing students. The results indicate that students who are DHH do not lag behind in small number enumeration as compared to hearing students but, rather, appear to perform better than their hearing peers in small number enumeration processes, as well as when conceptual knowledge about the part-whole relationship is involved. Our study suggests that the mathematical difficulties of students who are DHH are not related to difficulties in the small number enumeration, which offers interesting perspectives for further research.